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Consumer Credit Application
New/Demo   
Lease   
Graduate Program   
Individual   
Used   
Conditional Sale   
Future Value Purchase Program   
Both to sign   
Dealer Number
Dealer Name
Year
Make
Model Code
Please Print
Applicant
Mr.   
Ms.   
Last Name
First Name
Middle Name
Applicant S.I.N (Optional)
Date of Birth
MM DD YY
Current Address
Number and Street
Apt. Number
City
Province/Territory
Postal Code
Home Phone Number
Length
Yrs. Mths
Previous Address (if less than 3 years at Current Address)
Number of Years
Current Employer Name and Address
Business Phone Number
Trade/Occupation
Length
Yrs. Mths
Previous Address (if less than 3 years at Current Employer)
Trade/Occupation
Number of years
Co-Applicant
Mr.   
Ms.   
Last Name
First Name
Middle Name
Applicant S.I.N (Optional)
Date of Birth
MM DD YY
Current Address
Number and Street
Apt. Number
City
Province/Territory
Postal Code
Home Phone Number
Length
Yrs. Mths
Previous Address (if less than 3 years at Current Address)
Number of Years
Current Employer Name and Address
Business Phone Number
Trade/Occupation
Length
Yrs. Mths
Previous Employer Name and Address (if less than 3 years at Current Employer)
Trade/Occupation
Number of years
Email Address
Applicant   
Co-applicant   
Cellular Phone Number
Applicant   
Co-Applicant   
Applicant Gross Montly Salary
$
Co-Applicant Gross Monthly Salary
$
Other Income
$
Describe Other Income
Total Income
$
Financial Institution
Name
Address
Phone Number
Account Number
Savings   
Chequing   
Landlord/Mortgage Holder
Own   
Rent   
Name
Address
Phone Number
Monthly Rent Pmt.
$
Montly Mortgage Pmt
$
Relative Not Living With Applicant
Name
Address
Relationship to Applicant
Home Phone Number
Personal Reference Not Living With Applicant
Name
Address
Home Phone Number
Principal Driver's Name
Driver's Licence Number

The undersigned acknowledges and agrees that personal information in this credit application or provided subsequently, and personal information obtained from a credit/consumer reporting agency and/or financial institution, as described below, may be used by, collected by and/or disclosed to Honda Canada Finance Inc., operating as Honda Financial Services (hereinafter “HFS”) (including Canadian and foreign subsidiaries, affiliates, agents and contractors of HFS as well as the authorized dealer named above or any other authorized dealer(s) designated by HFS) for the following purposes: (i) evaluating the credit application and the undersigned’s eligibility for credit, (ii) entering into a conditional sales agreement and/or lease agreement, (iii) contract management and administration, including for credit, billing, collection, lien registration, insurance tracking and service and warranty purposes, (iv) marketing of goods: automobiles, motorcycles, all-terrain vehicles, power equipment, outboard motors and marine products, as applicable and related products and services, and (v) as reasonably necessary to protect the business interests of HFS and its customers. The undersigned authorizes telemarketing telecommunications to be made by or on behalf of HFS or the authorized dealer named above to the undersigned at the Home Phone Number of the undersigned set forth above. Please initial at the end of this sentence if the undersigned does not consent to HFS using and/or disclosing personal information for marketing purposes.

The undersigned acknowledges and agrees that personal information may be transferred to a third party or parties to be used for the same purposes described herein if the conditional sales agreement or lease agreement entered into by the undersigned is transferred or assigned to such third party or parties, or to an organization in connection with the due diligence for, and completion of, a business transaction, including, without limitation, a securitization or financing involving HFS or its subsidiaries or affiliates.
It is the express wish of the parties that this form and any related documents be drawn up and executed in English. Les parties ont expressément exigé que le présent formulaire et tous les documents s’y rattachant soient rédigés en anglais.

The undersigned further acknowledges and agrees, in connection with HFS making a determination in respect of this credit application, that (a) all information provided in this application is for the purpose of securing credit and warrants that it is true, correct and complete, (b) a credit/consumer report and other credit information containing personal information may be requested from a credit/consumer reporting agency and financial institution, (c) HFS is authorized to exchange with any credit/consumer reporting agency and financial institution credit information covering this application and details of any credit granted (including, without limitation, payment history relating to the credit granted) for the purposes of HFS determining creditworthiness and for the purposes of permitting other credit grantors to do the same. The undersigned may request HFS to inform the undersigned whether or not a credit/consumer report has been or may be referred to in connection with this transaction, and the undersigned may request the name and address of the credit/consumer reporting agency supplying the credit/consumer report.