C.A.

IFinancial
C.A.I. Financial APPLICATION

Date: ________________ Account no. _______

PLEASE PRINT CLEARLY AND FILL OUT IN FULL

Have you or your spouse ever applied for a loan from CAI Yes
Have you or your spouse ever received a loan from CAI Yes

No
No

Have you or your spouse ever co-signed for a loan from CAI Yes

When ___________________
When ___________________

No

For whom __________________________________

How did you hear about the CAI________________________________________________________

APPLICANT INFORMATION
Amount requested $_____________________
Purpose of loan __________________________________________________________uytrewq

Na`me

(please print) (first)_________________________ (last)_____________________

Maiden name or AKA ________________________________
*Fort McMurray - Street address _____________________________________________
City ___________________________

Postal ___________________

*Other Home - Street address _____________________________________________

City ___________________________

Postal ___________________

Home telephone ( ) _________________ Cell phone ( ) _________________

E-mail ________________________________
*Fort McMurray Current Rental Address (include camp name if living in
camp)___________________________________________________________________________________
Social Security no. ________-_______-________
Alberta drivers license no. _______________________________
Date of birth ____ /___ / _____

Canadian citizen: Yes __ No__

City of birth ________________________________

AB _______

In Alberta since: ________ If foreign born, emigrated from: ____________________________________

In Canada since: _______
Marital Status: Single __ Married __ Divorced __ Separated __ Widower __ Domestic partner __
Rent __ Own __ Rent/Mortgage $___________ / month
How long at this address: _________________________________
Applicants occupation ________________________________
Name of firm ___________________________________________
Salary (gross) $____________________ per ______________
Employed since _________________________________________
*Businessaddress_____________________________________City _____________ Postal ________
Phone ( ) ________________
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*Name of nearest close relative or friend___________________________________

Relationship _____________________________
Relatives address____________________________________City _____________ Postal Code ________
Phone ( ) ________________
*Name of nearest close relative or friend___________________________________
Relationship _____________________________
Relatives address____________________________________City _____________ Postal Code ________
Phone ( ) ________________

SPOUSE AND DEPENDENT INFORMATION

Spouses name(first)______________________

(second)______________

Spouses maiden name ________________________________________

Spouses Social Security no. ________-_______-________ Spouses Alberta drivers license no.
____________________________
Spouses date of birth _________ /_______ /___________
Spouses occupation __________________________________________
Spouses salary $__________ per _______ Name of firm ___________________________________
Employed since ___________
No. of dependents _____ Name________________ Age___
Name________________ Age___
Name________________ Age ___

BANK INFORMATION
Name of bank____________________________________________ Province ____
Type of account ____________________________City________________________
*Branch Address________________________________________________________
Name of bank____________________________________________Province ____
Type of account ____________________________City________________________
*Branch Address ________________________________________________________

CURRENT ASSETS AND LIABILITIES

Assets (savings, securities, car, equity on property, etc.) Amount Liabilities (mortgages, loans, credit cards, etc.) Amount Monthly
payment
______________________________________________________________________

$_____________

______________________________________________________________________

$_____________

______________________________________________________________________

$_____________

______________________________________________________________________

$_____________

WHAT WOULD YOU LIKE TO USE AS COLLATERAL (details)

2

________________________________________________________
________________________________________________________

CERTIFICATION OF COMPLETENESS AND ACCURACY,

and APPROVAL TO OBTAIN ADDITIONAL INFORMATION
I authorize the CAI to investigate my credit and personal history.

I authorize agencies and persons contacted by the CAI in connection with this
application (including credit reporting agencies, banks, and social service organizations)
to provide information about my credit and personal history to the CAI.

I certify that the information contained in this loan application is complete and
accurate.
Applicants signature _____________________________________________
Date _____________________
Spouses signature _____________________________________________
Date _____________________
BORROWERS ACKNOWLEDGEMENT OF TERMS AND CONDITIONS
I understand and agree that the following terms and conditions will apply to my loan:

I understand that if application is not filled out in full I will not be successful in
obtaining a loan.

There will be a minimum of 4% interest charged plus applicable fees. Depending on

applicant.

The cost of obtaining a credit report, facts report, inspection and lien search will be
deducted from the proceeds of the loan.

I will repay my loan according to the amounts and schedule stated in the promissory
note that I sign.

If I fail to make payments as agreed, then CAI will start collection proceedings against
me and my guarantors (each of whom is individually responsible for the full amount of the
outstanding balance).

I will immediately notify the CAI about any change in my address or in my ability to
make my payments as agreed.

Applicants signature _____________________________________________

Date _____________________
Spouses signature _____________________________________________
Date _____________________