Short Term Lease Credit Application Business Information Legal Company Name * Number of Years in Business * Number of Employees * Trade / Operating Name Website Address Address and Contact Information Corporate Address * {including Suite #, if applicable) Name and Title of Primary Contact * Email * Business Phone * City * Province * - Select -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon U.S Postal Code * In order to complete your application, please supply articles of incorporation along with the attached completed application. Upload Files In order to complete your application, please supply articles of incorporation along with the attached completed application.Files must be less than 2 MB.Allowed file types: jpg jpeg png txt pdf doc docx. Key Shareholders Name % Owned * Name % Owned * Financial Information Name of Bank * Bank Phone Number * Bank Contact (Account Manager) * Bank Contact Email Address * Financial Statements Availalble Year Ending * Month / Year Fleets Requirements/Details Fleet size * Asset Required * 1/2 Ton Trucks 3/4 Ton Trucks 1 Ton Trucks Cargo Van SUV Other Insurance Information Insurance Broker Name Name of Insured Address City Province - None -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon U.S Postal Code Insurance Company Name Broker Contact Name Phone Number Fax Number Policy Number Effective Expiry Date Third Party Liability Deductible * $ Comprehensive Deductible * $ Collision Deductible * $ By Completing this information you are confirming that your insurance policy has adequate coverage for rental and non-owned vehicles. Authorized Signature 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 evaluate your credit worthiness in relation to the financing of vehicle lease and service cards. In particular, you agree that Foss National, our affiliates, and any third parties acting on our behalf (hereinafter collectively “us”), may obtain a credit report or other credit information from any credit reporting agency, credit bureau and/or credit grantor. The Applicant is duly authorized to complete the application on behalf of this corporation, partnership or proprietorship and confirms that these cards will be used for business purposes. I confirm that I am an authorized signing officer of the aforementioned Company and have authority to bind the Corporation. Signer's First Name * Signer's Last Name * Signer's Title * Your Signature * Date * FAQ:
