Commercial Credit Application Zac Zawisza

Business Information

Business Type:

• Proprietorship
• Partnership
• Corporation

Legal Business Name:

Operating Name

Number of Years in Business

Business Description:

Business Address

City

Province

Contact Person Name

Business Phone

Business Email

Principal Information

Full Legal Name *

Date of Birth *

SIN Number:

Phone *

Email Address

Married *

• Yes
• No

Annual Salary

Home Address *

Postal code *

City

Province

Years at Address:

Ownership Details:

• Own Home
• Rent Home

Monthly Rent (If Rented):

Value of Home (If Own):

Mortgage Payment (If Own):

Mortgage Balance (If Own):

Vendor and Equipment Information

Equipment Status:

• New
• Used

Equipment Description:

Equipment Cost:

Term Requested

Vendor Name

Vendor Contact Person

Vendor Contact Phone

Vendor Contact Email

LeaseLine Information

How Did You Find LeaseLine?Existing Client Referred by a dealer Referred by a friend Internet Search AutoTrader CastanetKijijiSupply Post Other

Additional Comments:

Acknowledgement

I have read the terms & conditions below and agree. *

• LeaseLine is a trade name of LeaseLine Financial Services Corp (herein “LeaseLine”). The undersigned certifies to LeaseLine that the above information, as well as any other information provided to LeaseLine or it’s agents from time to time, is true and correct and may be used in connection with this credit application and any subsequent finance arrangement. Moreover, the undersigned authorizes and consents to LeaseLine’s collection, use and disclosure of any such information in accordance with LeaseLine’s Privacy Policy which includes, but may not be limited to, requesting credit information from one or more credit reporting agencies and disclosing all such information, correspondence and communication contemplated herein to one or more lenders and/or financials institutions and their agents for the purpose of arranging financing. The undersigned further authorizes and consents to LeaseLine saving all information, correspondence and communication from its customers for ongoing auditing, compliance and marketing purposes. Authorization and consent provided by digital means, including our online application form or a digital signature as an example, will be deemed to have the same force and effect as written Authorization.

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