Loan – Application Details

Business
Information about the Business
Business Name ----------------------------------
Business in operation since -----------
Number of employees ---------
Trade Name (optional) ------------------
Home office yes/no
Business type -----------------------------------------
Line of business ------------------------
Annual sales ($) ---------------------
GST number -------------------- RT 0001

Business contact information

Address -------------------------------------------
City --------------------
Province ---------
Postal code ----------------
Telephone --------------------------------------
Correspondence email for this request ----------------------------------
Website (optional) http://-------------------------------------------
Physical place of operations:----------------------------

Additional information
External accounting firm (optional) n/a
Name of external accountant (optional) n/a
Accountant’s telephone (optional) n/a

Communication preference
Correspondence language English

Owner(s)
Website (optional) http://-------------------------------------------
Physical place of operations ----------------
Additional information
External accounting firm (optional) n/a
Name of external accountant (optional) n/a
Accountant’s telephone (optional) n/a
Communication preference
Correspondence language English
1st Business Owner
Courtesy title ------------
First name ---------------
Last name -------------------
Alias (optional) n/a
Date of birth -------------------------
Email ----------------------------------
Home telephone ---------------------------
Mobile (optional) -----------------------------
Office telephone ______
Owned this business since --------------------

Residency status --------------------------

Owner occupation / position Director
% Owned / Controlled 100 %
Current personal address
Current home address ---------------------------
City -------------------
Province -----------------
Postal code -----------------
Have you lived at this address for at least
2 years?
Yes/NO

Communication preference
Correspondence language English

Project
Residency status -------------------------------
Owner occupation / position -----------------
% Owned / Controlled --------------%
Current personal address
Current home address -----------------------------
City ------------------
Province ON
Postal code -------------------
Have you lived at this address for at least
2 years?
Yes
Communication preference
Correspondence language English
About your project
What is the need or project for which your
are requesting a loan?
Equipment $------------------
Technology $------------------
Working capital $---------------
Total purchases $------------------
Project description

Referred by News

Signatures

Signed loan request