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Online Application

 

Please fill out the form below. If you have any questions or concerns, please feel free to contact us for further information.


* Required

Legal Business Name

Operating as (if applicable)

Year End

Years in business

Mailing Address

City/Town

Province

Postal Code

Phone

Cell

Fax

Email *

Principle Name(s)

Bank

A/R

Industry

Annual Revenue

Commercial Assets

Asset Name

Approx. Value

Approx. Balance

Financed With


Asset Name

Approx. Value

Approx. Balance

Financed With


Asset Name

Approx. Value

Approx. Balance

Financed With

Personal Statement

Applicant's Name

S.I.N.#

Date of Birth

Home Address

City/Town

Province

Postal Code

Phone

Cell

# of Years

Monthly Payment

Previous Address

City/Town

Province

Personal Assets (Approx. Value)

Home

Other Real Estate

Vehicle(s) (Total)

Cash

RRSP's

Stocks, Bonds, Investments

Other

Personal Liabilities (Approx. Value)

Mortgage

Other Mortgage

Vehicle(s) Loan/Lease (total)

Line of Credit

Other


I hereby certify the above information to be true and correct. We consent to HarbourEdge Leasing and assigns collecting and using the information gathered in order to determine our credit worthiness and also consents to the disclosure at any time of any information concerning the undersigned to any credit agencies and/or grantors with whom HarbourEdge Leasing has financial relations. I consent to receive communications from HarbourEdge Leasing by email or other forms of electronic communications and understand that I can withdraw my consent to receipt of electronic messages at any time.


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