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First Name*
Last Name*
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Phone Number*
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How Long Have You Had Your Auto Loan For?
0 - 8 Months
9 Months - 1 Year
1 Year - 2 Years
Over 2 Years
VIN
OR
What Model Year Is Your Vehicle?
Select model year
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
What Make Is Your Vehicle?
Select make
What Model Is Your Vehicle?
Select model
What Series Is Your Vehicle?
Select series
What Body Style Is Your Vehicle?
Select style
What Is The Mileage On Your Vehicle?
What Is Your Current Interest Rate?
Below 10%
10% to 14%
14% to 19%
20% and above
Amount Owing - Approx. How Much Do You have Owing On Your Current Auto Loan?
Who Is Your Current Lender?
Residential Status
Select Residential Status
Rent
Own with Mortgage
With Parents
Other
Home Address?
Time At Residence?
Less Than 2 Years
2 - 5 Years
6+ Years
What Was Your Previous Address?
What Is Your Monthly Rent / Mortgage Payments?
$0
$100 - $500
$500 - $1000
$1000 - $2000
$2000+
Current Employer Name (If Self-Employed please tell us your Company Name)
Current Employer Phone Number
Current Employer Address
Employed for 2+ years?
Yes
No
Previous Employer Name
Previous Phone Number
Monthly Gross Income (all incomes, excluding employment insurance)
Employment Type
Employed
Self-Employed
Retired
Other
What Is Your Job Title?
What Is Your Date Of Birth?
Credit Consent*
By clicking the box above, you are opting in to SafeLend Canada Ltd. or anyone of its lender partners to obtain your credit report from a credit reporting agency for the purpose of evaluating my credit worthiness in connection with my auto loan refinance application. I understand that this authorization will allow SafeLend Canada Ltd. Or any of its lender partners to use my credit report for assessing my eligibility for my auto loan refinance application.
