Initial Application Form

    BUSINESS DETAILS

    * field is required.

    Business Legal Name:
    Business Registration Type:
    Nature of Business:

    Physical Address with Postal Code:
    Contact Name:
    Telephone:

    APPLICATION DETAILS

    * Full Legal Name:
    * Date of Birth:
    * Cell Phone:
    * Address with Postal Code:
    * Own or Rent?
    * Have you ever filed for bankruptcy?
    * Present Employer:
    * Start Date:

    BUSINESS & APPLICANT FINANCIAL INFORMATION

    Value of Real Estate:
    $
    Personal Gross Annual Income:
    $
    Additional Monthly Income:
    $
    Monthly Mortgage or Rent Payment:
    $
    Company Gross Annual Revenue:
    $
    Company Net Annual Income:
    $
    Expected Additional Monthly Income from Equipment Purchase:
    $

    EQUIPMENT TO BE LEASED / FINANCED

    * Year:
    * Model:
    * New or Used:
    * Status:

    * Price:
    * Contact:

    ADDITIONAL COMMENTS & NOTES

    Additional Comments & Notes:

    With your signature, you certify that the information provided, collected, and attached to complete this application is true and correct. By signing below, you consent and authorize East to West Group of Companies and its lenders and representatives, at any time, obtain on an ongoing basis, verify, use, communicate with, and disclose to third parties (including credit reporting agencies, credit exchanges, lenders, leasing brokers, and credit grantors, on an ongoing basis) any of your credit, financial, and personal information dimmed necessary to complete, service or enforce any lease, ancillary deed, or transaction, including but not limited to assignments and securitizations. You authorize us to collect, hold, exchange, and disclose your personal information as requested to administer your contract and determine your insurance eligibility as required or permitted by law. You also authorize us to use your data for internal statistical analysis purposes. If you would like to review your personal information or revise existing data, have any questions, concerns, or comments regarding this application, please email info@ewgroup.ca (Attn: Privacy Officer) or mail unit 8 9613 192 St., Surrey, BC, V4N 4C7, Attn: Privacy Officer.

    SIGNATURE