Commercial Credit Application
Company Information
Full Legal Name
Years in Business
Operating Name
Type of Business
Address
City
Province
Postal Code
Telephone
( )
Fax
( )
Cell
( )
Email
Name of Bank
Acct. Mgr
Bank Phone
( )
Annual Sales
Trade Ref 1
Trade Ref 2
Principal/Guarantor Information (complete application for each principal/guarantor)
First Name
Middle Name
Last Name
Home Address
City
Province
Postal Code
Home Phone Number
( )
Years at Address
Months at Address
Previous Home Address
Previous City
Previous Province
Previous Postal Code
Previous Home Phone Number
( )
Years at Previous Address
Months at Previous Address
Own/Rent
Monthly Payment
Date of Birth
SIN #
- -
% Ownership of Business
Title
Name of friend or relative
Contact #

Assets
Liabilities
Cash in Chequing & Savings
Mortgage on Real Estate
Real Estate, Home (present value)
Auto Loans
Auto(s) Value
Auto(s) Yr & Type
Bank Loans
RRSP's Value
RRSP's with
Line of Credit
GIC's Value
GIC's with
Credit Cards
Other Assets Value
Other Assets Desc.
Other Debts
Other Debts Desc.
TOTAL ASSETS
TOTAL LIABILITIES
TOTAL NET WORTH = TOTAL ASSETS - TOTAL LIABILITIES
TOTAL NET WORTH
Vendor and Equipment Details
Supplier Name
Location
Contact
Telephone
( )
Fax
( )
Equipment Cost
Lease?
Finance?
Months
Purchase Option
Type of Equipment (Include: Make, Model, New/Used)

Notes
Additional Notes

COMPANY FINANCIAL STATEMENTS ARE REQUIRED FOR AMOUNTS OVER $35,000.00. TAX ASSESSMENTS REQUIRED FOR SOLE PROPRIETORSHIPS FOR AMOUNTS OVER $15,000.00.

I/We certify that all the information in this application is true and complete. I/We acknowledge that all the personal information gathered maybe used by IndCom Leasing Inc., its funders, agents and assigns, to assess my credit worthiness, provide products, and administrate the contract and to perfrom services as may be requested by me. IndCom Leasing Inc. may also disclose my personal information to third parties such as but not limited to credit reporting agencies, financial institutions, financing companies, securitization organizations and my insurance agent or company. IndCom Leasing Inc. may also disclose my personal information where they are required or premitted by law to do so. Subject to legal and contractual requirements, you may refuse or withdraw your consent to certain of the identified purposes at any time by contacting the IndCom Leasing Inc., Chief Privacy Officer. By executing this document below, I have consented to these uses and disclosures.