Personal Vehicle / Trailer Lease Application Please ensure all required fields are completed. Fields marked in Orange with a * are required.PrincipalFull Legal Name:*Email:* Phone:*Date of Birth* YEAR MON DAY SIN Number:*Married:*YesNoHome Address:*Time at Address:*City:*Province:*Postal Code:*Ownership Details:*Own HomeRent HomeMortgage Payment (If Own):Monthly Rent (If Rented):Value of Home (If Own):Mortgage Balance (If Own):Employment InformationEmployer:Employer Address:Income ($):Occupation:How Long:Contact Person:Phone:Previous Employer (If less than 2 years):How Long:Gross Income ($):Contact Person:Other Income:Vendor and EquipmentDealer Name:Phone:Email: Sales Rep:Equipment Cost:Term Requested:Serial Number:Equipment Status:NewUsedMake:Model:Km's:Trailer Length:Leaseline Contact:- Select Name -Aidan GregoireBob ChalutChad LuiderJeff EatonKari RobbKris HartungKyle SwainRob BirrellRobert VincentSean WarnesStephanie BoyleNoneHow Did You Find LeaseLine?- Select One -AutoTraderCastanetExisting ClientInternet SearchKijijiReferred by a DealerReferred by a FriendSupply PostOtherAdditional Comments:Confirm Age:* I confirm that I am 19 years of age or older. Newsletter Sign Up I would like to sign up for the Newsletter. By proceeding with this online application, you agree with Leaseline’s Privacy Policy, and you will be deemed to have provided your written Authorization and Consent to Leaseline’s use and disclose of your business and personal information in accordance with our Standard Application Form as follows. Leaseline is a trade name of Leaseline Financial Services Corp (herein “Leaseline”). The undersigned certifies to Leaseline that the above information is true and correct. Moreover, the undersigned authorizes and consents to Leaseline’s collection and use of any such information as may be required at any time in connection with this credit application from any credit reporting agency or credit grantor and to the disclosure of any information concerning the undersigned to any credit reporting agency or any credit grantor. In particular, the undersigned authorizes LeaseLine and/or LeaseLine's financial affiliates to request a copy of the undersigned’s credit report and to share the information on such credit report with one or more financial institutions. The undersigned further authorizes and consents to the collection, use, and disclosure of personal information by Leaseline or its representatives and the persons referred to in the related lease, finance, or rental agreement for the above purposes and the purposes described in the related lease, finance, or rental agreement. If undersigned’s application is approved, then the undersigned authorizes Leaseline to utilize the information referenced herein to administer the undersigned’s contract, determine insurance eligibility, and secure the assets being financed, or as required or permitted by law. The undersigned further authorizes Leaseline to use the information referenced herein for internal statistical analysis purposes and for Leaseline to retain an internal file containing some or all of the undersigned’s personal information for future reference or a future credit application.Agreement:* I have read the terms & conditions above and agree. This iframe contains the logic required to handle Ajax powered Gravity Forms.
