Camex Credit App Corporate2a - Camex Equipment
CAMEX EQUIPMENT SALES & RENTALS INC. 1806 - 2 Street, Nisku, AB T9E 0W8 Tel: 780.955.2770 Toll Free North America: 877.955.2770
CREDIT APPLICATION FINANCE: Fax: 780.955.3735 [email protected] Business (Legal Name): Operating as: Same
Corporation
Or as:
How Long in Business:
Partnership
Proprietorship Street:
Legal Address: Tel:
Years
Town/City:
Cell:
Province/State:
Fax:
Postal/Zip Code:
Email:
Website:
Physical Address/Legal Land Description:
Management Structure: Key Officers Name:
Title Ownership:
%
Name:
Title Ownership:
%
Name:
Title Ownership:
%
Have any of you ever been bankrupt?: Yes
No
Social Security #:
Date of Birth (mm/dd/yyyy):
Social Security #:
Date of Birth (mm/dd/yyyy):
Social Security #:
Date of Birth (mm/dd/yyyy):
Have any of you ever had a repossession?: Yes
No
If yes to either of the above questions, please provide details: Are you a Home Owner?: Yes
No
Nature and History of Business:
Business Assets and Business Liabilities: Asset Description:
Value:
Total Business Assets:
Creditor Name & Address:
0.00
Proceed to page 2
Monthly Payment:
Balance Owing:
Total Business Debts:
0.00
Total Business Assets - Total Business Debts = Net Worth:
0.00
Personal Net Worth Statement: Personal Information: Applicant’s First Name:
Initial:
Last Name:
SIN#:
Age:
DOB:
Spouse’s First Name:
Initial:
Last Name:
SIN#:
Age:
DOB:
Street:
Home Address:
Town/City:
Bus. Phone:
Home Phone:
Cell Phone:
Province/State:
Fax:
Postal/Zip Code:
How Long - Years:
Email:
Present Employer:
Occupation:
Years/Months:
Spouse’s Employer:
Occupation:
Years/Months:
Cash Flow Analysis: Personal Income: Other Income: Spouse’s Income: Total Annual Income:
0.00
Personal Assets and Personal Liabilities: Asset description:
Value:
Creditor Name & Address:
Monthly Payment:
Balance:
Home/Lot/Acreage: Home/Lot/Acreage: Home/Lot/Acreage: Autos: Autos: Autos: Cash/Savings/GIC’s/RRSP’s: Cash/Savings/GIC’s/RRSP’s: Other: Other: Other: Total Assets:
0.00
Total Debts:
0.00
Net Worth:
0.00
The Applicant(s) affirm that all information given above is true and complete. The Applicant(s) consent to Camex Equipment Sales & Rentals Inc. obtaining from any Credit Reporting Agency or Credit Grantor such information as the dealer may require at any time in connection with the credit hereby applied for and consents to the disclosure or exchange at any time of any information concerning the applicant(s) to any Credit Reporting Agency or Credit Grantor with which the dealer deals.
Date:
04/07/2017
Applicant’s Signature:
Date:
04/07/2017
Applicant’s Signature:
Camex’s Privacy Policy
CREDIT APPLICATION FINANCE: Fax: 780.955.3735 [email protected] Business (Legal Name): Operating as: Same
Corporation
Or as:
How Long in Business:
Partnership
Proprietorship Street:
Legal Address: Tel:
Years
Town/City:
Cell:
Province/State:
Fax:
Postal/Zip Code:
Email:
Website:
Physical Address/Legal Land Description:
Management Structure: Key Officers Name:
Title Ownership:
%
Name:
Title Ownership:
%
Name:
Title Ownership:
%
Have any of you ever been bankrupt?: Yes
No
Social Security #:
Date of Birth (mm/dd/yyyy):
Social Security #:
Date of Birth (mm/dd/yyyy):
Social Security #:
Date of Birth (mm/dd/yyyy):
Have any of you ever had a repossession?: Yes
No
If yes to either of the above questions, please provide details: Are you a Home Owner?: Yes
No
Nature and History of Business:
Business Assets and Business Liabilities: Asset Description:
Value:
Total Business Assets:
Creditor Name & Address:
0.00
Proceed to page 2
Monthly Payment:
Balance Owing:
Total Business Debts:
0.00
Total Business Assets - Total Business Debts = Net Worth:
0.00
Personal Net Worth Statement: Personal Information: Applicant’s First Name:
Initial:
Last Name:
SIN#:
Age:
DOB:
Spouse’s First Name:
Initial:
Last Name:
SIN#:
Age:
DOB:
Street:
Home Address:
Town/City:
Bus. Phone:
Home Phone:
Cell Phone:
Province/State:
Fax:
Postal/Zip Code:
How Long - Years:
Email:
Present Employer:
Occupation:
Years/Months:
Spouse’s Employer:
Occupation:
Years/Months:
Cash Flow Analysis: Personal Income: Other Income: Spouse’s Income: Total Annual Income:
0.00
Personal Assets and Personal Liabilities: Asset description:
Value:
Creditor Name & Address:
Monthly Payment:
Balance:
Home/Lot/Acreage: Home/Lot/Acreage: Home/Lot/Acreage: Autos: Autos: Autos: Cash/Savings/GIC’s/RRSP’s: Cash/Savings/GIC’s/RRSP’s: Other: Other: Other: Total Assets:
0.00
Total Debts:
0.00
Net Worth:
0.00
The Applicant(s) affirm that all information given above is true and complete. The Applicant(s) consent to Camex Equipment Sales & Rentals Inc. obtaining from any Credit Reporting Agency or Credit Grantor such information as the dealer may require at any time in connection with the credit hereby applied for and consents to the disclosure or exchange at any time of any information concerning the applicant(s) to any Credit Reporting Agency or Credit Grantor with which the dealer deals.
Date:
04/07/2017
Applicant’s Signature:
Date:
04/07/2017
Applicant’s Signature:
Camex’s Privacy Policy
