Corporate Credit Application

Business Information

Business Legal Name*

Trade Name (doing business as)*

Type of Operation*

Proprietorship
Partnership
Incorporated

Type of Business*

Business Address*

Street Address City Province Postal Code

Business Phone*

Business Website URL

Business Email Address*

A/P Contact

A/P Contact Name*

First Last

A/P Contact Phone*

A/P Contact Email Address*

Head Office

Head Office Address*

Same as business address

Street Address City Province Postal Code

Billing

Billing Address*

Same as business address

Street Address City Province Postal Code

P.O. Required*

Yes
No

Email Statements/Invoices?*

Yes
No

Statements/Invoice Email Address*

Bank Reference

Bank Name*

Brank Branch #*

Bank Address*

Street Address City Province Postal Code

Trade References

Trade Reference #1 Name*

First Last

Trade Reference #1 Phone*

Trade Reference #1 Email Address

Trade Reference #2 Name

First Last

Trade Reference #2 Phone

Trade Reference #2 Email

Credit

Credit Limit Required ($)*

Payment Options*

EFT
Cheque
Credit Card

Terms*

15 Days
30 Days

Authorization

You must agree to the following to submit your application*

You confirm that the information you have given us in respect of this application is true and complete, and you authorize us to rely on and use this information in order to confirm your identity and evaluate your credit worthiness, in relation to the financing contract being entered into. In particular, you agree that we, our affiliates and any third parties acting for us or on our behalf, may obtain a credit report or other credit information from any credit reporting agency, credit bureau or credit grantor, and may hold, use, exchange and disclose such information for the purposes identified above.