Legal Company Name*
Operating As*
Sales Rep.
Vehicle you are interested in
Applying for
LeaseFinance
Deposit Amount
Type of Business
Year Started
Business Phone Number*
No. & Street
City
Province
Postal Code
Fax Number
Email Address*
Own or Rent Business Property
Last Fiscal Year's Sales
Owner/Operator Name
Address*
Phone Number
BANK NAME NO. & STREET
CITY
PROVINCE
POSTAL CODE
CHECKING ACC'T NUMBER
CONTACT NAME
BANK NAME & ADDRESS (IF ABOVE LESS THAN 2 YRS.)
CHECKING ACCOUNT NUMBER
COMPANY FROM WHICH LAST CAR WAS LEASED/FINANCED
Address
MONTHLY PAYMENT
1. MAJOR TRADE REFERENCES
Name
YRS. ASSOCIATED
2. MAJOR TRADE REFERENCES
I/WE HERBY CERTIFY THAT THE INFORMATION GIVEN IN MY APPLICATION IS COMPLETE AND IS GIVEN FOR THE PURPOSE OF OBTAINING THE FINANCIAL. SERVICES APPLIED FOR. 1/WE AUTHORIZE THE RECEIPT AND EXCHANGE OF INFORMATION ABOUT ME/US WITH YOUR ALLIANCES FROM TIME TO TIME AS. YOU DEEM APPROPRIATE AND TO THE SHARING OR EXCHANGE OF REPORTS AND INFORMATION WITH THE CREDIT REPORTING AGENCIES, CREDIT BUREAUS,MORTGAGE INSURANCES, AND/OR ANY OTHER PERSON OR CORPORATION FROM WITH WHOM I/WE HAVE TO PROPOSE TO HAVE A FINANCIAL RELATIONSHIP. SIGNATURE*