Lease Application Personal Lease application Fill online form below or download fillable PDF here Personal Lease application Applicant Surname Given Name Date of Birth Marital Status Address Phone How Long There Own or Rent Previous Address if less than 2 years at above Email Address Rent or Mortgage Payment Amount Applicant Employer (if any) Position Length of Employment Personal Net Worth of Primary Applicant: Asset Description Value Liability Description Value Cash $ Credit Cards, Lines of Credit $ RRSP $ Installment Loans $ Vehicles $ Loan on Vehicle $ Real Estate $ Mortgage $ Other $ Other $ Total Assets > Total Liabilities > (Total Assets – Total Liabilities) Net Worth > Monthly Income Income Source(s): Gross Net Total Monthly Income Equipment Info Equipment Supplier Phone No Sales Rep Cost Supplier Email Additional Information 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, 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 (hereinafter collectively “us”, “we”, or “our”), 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. If your application is approved, you authorize us 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 assets being financed, or as required or permitted by law. You also authorize us to use your personal information for internal statistical analysis purposes. We will keep a file containing some or all of your personal information. You have a general right to access and rectify the personal information in this file by making a written request. Corporate Lease application Fill online form below or download fillable PDF here Corporate Lease application Equipment Info Equipment Sales Rep Supplier Phone No Cost Supplier Email Additional Information Company Info Full Legal Name: Phone Number Operating Name: Contact Email Years In Business Type of Business Number of Employees Address City Province Postal Code Shareholder Info No1. Name Date of birth Home Address Cell Phone Home Phone Own/Rent How Long? Market Value Mortgage Balance Shareholder Info No2. Name Date of birth Home Address Cell Phone Home Phone Own/Rent How Long? Market Value Mortgage Balance I/We hereby certify that all information given in this application and any attachments hereto, is true and correct, and are made for the purposes of obtaining credit. By signing below, I/We consent to Agro Capital, or its assigns, obtaining from any credit reporting agency or credit grantor, such information as it may require at any time in connection with the credit hereby applied for, and consent to the disclosure at any time of any information concerning the undersigned to any credit reporting agency or to any credit grantor with whom the undersigned has financial relations.
