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					                                                                                                                            Fred Schultz
                                                                                                                    Cell: (519) 580-1595
                                                                                                                   Fax: 1-866-681-2965
CREDIT APPLICATION                                                                                       Email: fschultz@cleleasing.ca
Complete in block letters
LESSEE INFORMATION
Legal Name:                                                                                            Source:
Address:                                                          Telephone:
City/Prov.:                                                       Fax:
Postal Code:                                                      Cellular:
Contact:                                                          Pager:
Type of Business:                                                 Since:
Building Owner's Name:
Address:
BANK INFORMATION (include a sample cheque)
          Commercial             Personal                                   Commercial                 Personal
Name:                                                             Name:
Address:                                                          Address:
City/Prov/PC:                                                     City/Prov/PC:
Contact:                                                          Contact:
Telephone:                                                        Telephone:
Fax:                                                              Fax:
Account No.:                                                      Account No.:
Credit Line: $                                                    Credit Line: $
Utilized:                                                         Utilized:
SUPPLIER INFORMATION
Name:                Action Trailers                                                                Prog. No.:
Address:             4728 Egremont Dr. (Hwy 22)                   Contact:          Shane Thompson
City/Prov.:          Strathroy Ontario                            Telephone:        519-245-8802
Postal Code:         N7G 3H3                                      Fax:
EQUIPMENT DESCRIPTION (attach quote to the credit application)
Quantity             Description                                                                                         Price




PAYMENT TERMS
Total Cost:                                                       Term (months):
Deposit:                                                          Exchange Value:
To Finance:                                                       Number of payments per year:
PERSONAL INFORMATION
Name:                                                             Name:
Address:                                                          Address:
City/Prov.:                                                       City/Prov.:
Postal Code:                                                      Postal Code:
Own:     How Long:     Mortgage/ Rent Pmt:$                       Own:     How Long:     Mortgage/ Rent Pmt:$
Outstanding Amount:$         Market Value:$                       Outstanding Amount:$         Market Value:$
Mortgage/ Landlord Name                                           Mortgage/ Landlord Name
Tel. (home):                                                      Tel. (home):
S.I.N:                                                            S.I.N:
Date of Birth:                                                    Date of Birth:
CONSENTMENT AND SIGNATURE: the undersigned certifies that the above information is true and correct.By signing below, I/we consent to Cle
Leasing and/or its warranty obtaining from any Credit Reporting Agency or Credit Garantor with whom the undersigned has financial relations, any
information it may require at any time in connection with the credit application hereby, and consent to its full disclosure at any time.


Signature (A)                                     Signature (B)                                                  Date
                                                                                                                         DEM01-A / REV. 12/2007
                                                                                                                                                                Fred Schultz
                                                                                                                                              Cellular: (519) 580-1595
                                                                                                                                                    Fax:1-866-681-2965
CONSUMER APPLICATION - SELF-EMPLOYED
                                                                                                                                          Email: fschultz@cleleasing.ca
Complete in block letters
                                                                                                                                              Source:

PERSONAL INFORMATION                                                       EMPLOYER
Name:                                                                      Name:
Address:                                                                   Contact:
City/Prov.:                                                                Title:                                                                    Since:
Postal Code:                                                               Tel. (office):
Tel. (home):                                 Tel. (office):                Status:             Permanent         Temporary                Seasonal                  Contract

S.I.N.:                                                                    If self-employed, indicate type of business:
Date of Birth:
Marital Status:                                                            Tel. (office):                                                            Since:
SPOUSAL INFORMATION                                                        SPOUSAL EMPLOYER
Name:                                                                      Name:
Title:                                                                     Contact:
Status:        Permanent      Temporary      Seasonal         Contract     Tel. (office):                                                            Since:
FINANCIAL INFORMATION (attach a sample cheque)
Name:                                                                      Name:
Address:                                                                   Address:
Account No.:                                                               Account No.:
REVENUE                                                                    SPOUSAL REVENUE
Monthly Gross Income:                                                      Monthly Gross Income:
Other Revenue:                                                             Other revenue:
DWELLING
Tenant?            Yes      No            Monthly Rent:                     Owner?                 Yes     No                          Municipal Taxes:
ASSETS
Building Description:                                                                                                                         Value ($):
Car Description:                                                                                                                              Value ($):
Furnitures:                                                                                                                                   Value ($):
Other:                                                                                                                                        Value ($):
Other:                                                                                                                                        Value ($):
Savings/Investments:                                                                                                                          Value ($):
                                                                                                                                       TOTAL ASSETS:
LIABILITIES
CREDITORS                                                                                                         Original Amount        Monthly Pymt.           Balance
Hypothecary Creditor:
Car Creditor:
Other Creditors (credit cards, etc.):




                                                                                                                                 TOTAL LIABILITIES :
SUPPLIER
Name:                                                                      Contact:                                                          Prog. No.:
Address:                                                                                                                  Telephone:
                                  ******** Please attach your quotation to the credit application ********
PAYMENT TERMS
Cost:                                       Exchange:                               Deposit:                                            Term (months):

CONSENTMENT AND SIGNATURE: the undersigned certifies that the above information is true and correct. By signing below, I/we consent to Cle Leasing and/or its
warranty obtaining from any Credit Reporting Agency or Credit Garantor with whom the undersigned has financial relations, any information it may require at any time in
connection with the credit application hereby, and consent to its full disclosure at any time.



Signature                                                                                      Date
                                                                                                                                                          DEM02-A / REV. 12/2007

				
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