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Please fill in as many lines as possible.  The lines with the red asterisk must be filled in. If you do not have an answer for any of them at this moment just put "n/a" in the field so the form will still submit.  Please note that all information submitted is kept in the strictest of confidence.  Thanks.

 

I hereby certify that the information given above is true, accurate and complete as at the statement date. I fully understand that such information shall be used to determine my credit worthiness. I understand that ALL INFORMATION WILL BE VERIFIED and any information that proves inaccurate will result in the application being terminated and the deposit accompanying the application may be retained by the dealer. I authorize Gardelli Motors to obtain all the information it requires.

 

Phone:  (519) 521-4782                                   Email:  gardellimotors@rogers.com