Visio-Registration EN.Vsd

Multi–Lender Portal Dealer Registration Form

To register with DealerTrack Canada , please print this form and complete the General Dealership Registration and User Information sections.

Once complete, please fax to DealerTrack Canada at 1-866-466-7031 . A Dealer Support Representative will process your application and will contact you to finalize your enrolment.

If you have any questions , please call us at 1-866-360-3863.

General Dealership Registration Section Dealership Operating Name

Dealership Legal Name

Street Address

City Province Postal Code

Phone Number Fax Number

Do you belong to a retailer group of companies? Name of group (if Yes) Yes No

Does your dealership have a website? Name of website (if Yes) Yes No

Do you sell warranty products? Name of providers (if Yes) Yes No

Do you sell insurance products? Name of providers (if Yes) Yes No

Do you use DMS, CRM, or F&I software? Name of providers (if Yes) Yes No

Page 1 of 3 Dealership’s Lenders: (check all that apply)

NATIONAL REGIONAL

BMO Bank of Montreal 1st Calgary Credit Union Caisse Populaire Servus Credit Union

FinancialLinx 1st Ontario Credit Union Carfinco Shaw Leasing Community Savings Credit Royal Bank AJM Tricor Union Alterna Savings and Scotiabank Conexus Credit Union Westminster Savings Credit Union Credit Union Scotia Dealer Advantage Alphera Financial CU Dealerlink Windsor Family Credit Union Services TD Canada Trust WS Leasing ATB Financial Four Star Auto Lease VFC General Bank of Canada Bank West Other (please specify) Wells Fargo National Bank of Saskatoon CU Canada

Do you use a Third Party F&I Provider / Broker? Yes No (If you answered Yes , please complete the following Broker contact information) (Broker) Legal Business Name

(Broker) Street Address

(Broker) City (Broker) Province (Broker) Postal Code

(Broker) Phone Number (Broker) Fax Number

User Information Section Dealership Contact Name: (Will serve as Dealership’s primary contact for administrative purposes) First / Given: Last/Surname

Phone Number Fax Number Email Address

Secret Question (Will be used to verify you identity to DealerTrack Canada...choose only one question and supply an answer)

What is your pet’s name?

What is your favourite team? For DealerTrack Canada Use only: In what city were you born? User Name:

To add additional users, please complete the following page

Page 2 of 3 Additional Users: Dealer Basic profile allows for standard functionality such as creating and submitting applications

Dealer Administration profile allows for standard functionality PLUS holds responsibility of managing user(s), authorizing credit bureau activity, lender assignment, and dealer contact information

User 1: Please select a security level: Dealer Administration Dealer Basic First / Given: Last/Surname