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Business: Incorporated Company Lease Application

  Thank you for considering Accurate Leasing for your leasing needs. Please supply the information requested below to help us determine the best leasing options for your particular needs. Fields marked with an asterisk should be filled out. All other fields are optional but will assist in speeding up the lease process. The information you provide is confidential and is used for the sole purpose of pre-approving your lease application. Call us at (800) 595-1477 if you need help filling in this application.
* Full Legal Name: * Operating Name:
Company Address: City:
Province: Postal Code:
* Phone: Fax:
E-Mail Address: Website Address:

Contact Person
Salutation:
First Name: Last Name:

Company Details
Landlord/Mortgagee: Type of Business:
No. of Employees: No. of Years in Business:
Annual Gross Revenue/Sales: Is Company Publicly Traded?:
Yes
No

Business Banking
Business Bank Name: Branch:
Phone: Contact:
Business Bank Account No.: Years with Bank:

References
Trade Reference (Name): Phone:
Trade Reference (Name): Phone:

Principal 1
* Last Name: * First Name:
Address: City:
Province: * Phone/Cell No.:

Principal 2
Last Name: First Name:
Address: City:
Province: Phone/Cell No.:
Are there more than 2 principals?  
Yes
No
 

Equipment Supplier for the Lease
Supplier Name (if available): Supplier Representative:
Phone: Fax:
E-Mail Address:  
 
Description of Equip. to be Leased:
Equipment Cost (pre tax): Term Requested (months):

Please Add Your Comments:


Application Authorization and Consent

I hereby represent all information is true, correct and complete. Applicant agrees that the act of inserting your name in the space below constitutes your valid electronic signature and evidences your agreement with the same effect as your ink-signed signature. Furthermore the Applicant confirms that the information provided in respect to this application is TRUE and COMPLETE and authorizes Accurate Leasing Ltd. to reply 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 Accurate Leasing Ltd. and its Affiliates and any third parties acting on behalf of Accurate Leasing Ltd. may obtain a credit bureau 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. If the application is approved, the undersigned authorizes Accurate Leasing Ltd. to collect, hold, use, exchange and disclose your personal information as required, in order to administer your contract, determine your insurance eligibility and secure the asset being financed or as required or permitted by. You also authorize Accurate Leasing Ltd. to use your personal information for internal statistical analysis purposes. We will keep a file containing some or all of your personal information at 814-1661 Portage Ave. Winnipeg, MB R3J 3T7 from time to time. You have a general right to access and rectify the personal information in this file by making a written request to the above address attention: Privacy Officer.

Applicant 1:

Applicant 2:
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Partnership Lease      Proprietor Lease
Incorporated Lease      Personal Lease


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