Retail Credit Application (Auto)
Applicant's Information
Complete Legal Business Name:
(hereinafter known as applicant)
Are you a
Sole Proprietorship
Partnership
Incorporated
Operating as (if applicable):
How long has this company been in business?
----
1yr
2yrs
3yrs
4yrs
5yrs
6yrs
7yrs
8yrs
9yrs
10yrs +
Is your business HST exempt?
Yes
No
How long have you operated this business?
----
1yr
2yrs
3yrs
4yrs
5yrs
6yrs
7yrs
8yrs
9yrs
10yrs +
Mailing Address:
Street:
Apt:
City:
Province:
----
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland/Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code:
Email:
Bus Phone:
-
Fax:
-
Cell:
-
Accounts Payable Contact Person:
Phone:
-
Email:
Owner/Officer #1:
First Name:
Last Name:
Date of Birth:
(mm/dd/yyyy)
Street:
Apt:
City:
Province:
----
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland/Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code:
SIN#
Owner/Officer #2:
First Name:
Last Name:
Date of Birth:
(mm/dd/yyyy)
Street:
Apt:
City:
Province:
----
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland/Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code:
SIN#
Do you own your own place of business or do you rent?
Own
Rent
If you are renting, who is your landlord?
First Name:
Last Name:
Phone:
-
Banking Information
Financial Institution:
Street:
City:
Province:
----
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland/Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Contact First Name:
Last Name:
Phone:
-
Submit Your Application
BEFORE SUBMITTING ANY INFORMATION TO US PLEASE READ, UNDERSTAND AND AGREE TO THE FOLLOWING TERMS AND CONDITIONS
The Applicant certifies that the above information is true and correct. By submitting this application electronically, the Applicant authorizes McDougall Energy Inc. or its agent to conduct credit history checks for the purposes of credit approval. The Applicant further agrees that this authorization is ongoing and to be used by McDougall Energy Inc. only when reasonably necessary for the purposes of monitoring the Applicant’s account and/or for debt collection. The Applicant further authorizes McDougall Energy Inc. or its agent to contact banking and trade references. McDougall Energy Inc. collects credit information for the purpose of credit approval, account monitoring and debt collection only. We do not distribute, sell or disclose any customer information without consent or unless required to do so by law. Our files are kept secure. Our privacy policy is available upon request.
By submitting this application electronically, the Applicant agrees to keep their account current and in good standing. Interest in the amount of 2% per month shall be charged for all accounts past due. The Applicant further agrees that should collection proceedings or legal action be necessary to collect on the Applicant’s account, the Applicant agrees to be responsible for all costs incurred by McDougall Energy Inc. or their authorized agent, to collect payment.
I HAVE READ AND AGREED TO THE TERMS AND CONDITIONS