Credit Application

Buyer's Information

Full Legal Name
Address
City/Province
Postal Code
Home No.
Cel/Work No.
SIN No.
Birthdate : (MM/DD/YYYY)
- -
Residence :
Own
Rent
How Long
(Yrs)

Co-Buyer's Information

Full Legal Name
Address
City/Province
Postal Code
Home No.
Cel/Work No.
SIN No.
Birthdate : (MM/DD/YYYY)
- -
Residence :
Own
Rent
How Long
(Yrs)

Buyer's Employment

 
Employer's Name
Address
City/Province
Postal Code
Phone No.
Self Employed :
Yes
No
Occupation
Gross Monthly Income
  $/Mo
How Long
(Yrs)(Mos)

Co-Buyer's Employment

 
Employer's Name
Address
City/Province
Postal Code
Phone No.
Self Employed :
Yes
No
Occupation
Gross Monthly Income
  $/Mo
How Long
(Yrs)(Mos)

Buyer's Mortgage / Rent Information

Bank / Mortgage Co.
Monthly Payment
  $/Mo
Home Value
  $
Mortgage Balance
  $

 

The undersigned certifies the above information to be true and correct. By signing below, I consent to Leading Edge. (herein referred to as "Leading Edge") and its subsidiaries and affiliates 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.

Leading Edge and its subsidiaries and affiliates may use my personal information (including credit and other financially-related information) and disclose it to each other when it is necessary in order to serve a customer, to meet legal and regulatory requirements, and for internal audit, statistical and record keeping purposes. Leading Edge may collect and use my personal information with subsidiaries and affiliates in order to identify and inform me of products and services that they offer.

Although not required by law, Leading Edge and its subsidiaries and affiliates may collect, use and share my SIN to help ensure accuracy on credit checks and for statistical and record-keeping purposes.

** Have you ever declared Bankruptcy in the last 7 years : Yes No

Signature Of Buyer
Date
Signature Of Co-Buyer
Date

Equipment Information

Year
Make
Model
New
Used
Purchase Amount  $
F & PDI  $
Access  $

Trade  Year
Make
Model
Trade-in Value  $
Lien on Trade?
Yes No
(If "Yes") Bank
Balance  $