Used Heavy Iron 1-519-442-3405, Used Massey Ferguson Tractors, Used Hyster Forklift, Used Clark Forklift, Used Kenworth Daycab, Used Storage Trailers, Used Backhoes, Used Hiab Cranes, Used Grove Aerial Lifts, Used scissor Lifts, Used Electric Booms, H130F, H210XL, H115XL, H155XL Cab, H110XL, H30XM.

Finance

Company Information as Applicable
Legal Name		Corporation #
TradeName		Phone
Address		Fax
City		Prov
PostalCode
Contact		Position
Type of Business		Years inBusiness
Insurancebroker		Contact
Telephone
Owner / Partner / Personal Information asApplicable
Name		Phone
Address		Cell
City		Prov
Postal Code
Occupation		Employer
SIN		How longemployed
Date ofBirth		Gross monthly income
Banking Information
Bank		Contact Name
Address		Prov
Postal Code		Account number
Phone		Fax
TradeReferences
Company		Address
Contact		Phone
Fax

Company		Address
Contact		Phone
Fax

Company		Address
Contact		Phone
Fax
Other Information
PST exemption #		GST exemption #
A/P contact		Telephone
Reason for seeking credit	Rental Parts Service Equipment Lease Other
Purchase order required	Yes No	Amount ofcredit requested
You confirm that the information you have given us in respect of thisapplication is true and complete, and you authorize us to rely on anduse this information in order to confirm your identity, evaluate yourcredit worthiness, in relation to the credit being sought. Inparticular, you agree that we, our affiliates and any third partiesacting for us or on our behalf (hereinafter collectively"us","we" or"our"), may obtain a credit report or other credit information from anycredit reporting agency, credit bureau or credit grantor, and may hold,use, exchange and disclose such information for the purposes oftransacting business with Finance Repo. If yourapplication is approved, you authorize us to collect , hold use,exchange and disclose your personal information, as required, in orderto administer, service or enforce any lease, ancillary deed ortransaction including but not limited to assignments andsecuritizations. We will keep a file containing some or all of yourpersonal information at the offices of Finance RepoYouhave the general right to access and rectify the personal informationin this file by making a written request to our offices. Terms Net in30 days, accounts overdue may have a S/C applied and may be placed oncredit hold. If there is a default collection fees will be theresponsibility of the customer.
Position		Print Name
Date
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