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Commercial Credit Application (Business)
Office:
Territory Manager:
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 +
What industry do you operate within?
----
Agriculture, forestry and fishing
Arts, sports and recreation
Catering and accommodation
Construction
Education
Health and social care services
IT and telecommunications services
Manufacturing
Media and creative services
Mining, energy and utilities
Personal services
Professional and business services
Retail, hire and repair
Wholesale
Automotive Repair
Trucking/Transportation
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 require cards for cardlock services?
Yes
No
If yes, how many?
From which McDougall branch will you be receiving products/services?
----
Blind River
Chapleau
Cochrane
Manitoulin
Nanaimo BC
New Westminster BC
Red Lake
Sault Ste. Marie and Area
Timmins
Thessalon
Thunder Bay
Greater Toronto Area
How much credit do you think you will need? $
/per month
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:
-
If you are sole proprietor, do you own your place of residence or rent?
Own
Rent
Who currently provides your fuel requirements?
Phone:
-
Trade References
Business Name:
Type of Supplier:
Street:
Phone:
-
How long with them?
----
1yr
2yrs
3yrs
4yrs
5yrs
6yrs
7yrs
8yrs
9yrs
10yrs +
Fax:
-
Contact First Name:
Last Name:
Business Name:
Type of Supplier:
Street:
Phone:
-
How long with them?
----
1yr
2yrs
3yrs
4yrs
5yrs
6yrs
7yrs
8yrs
9yrs
10yrs +
Fax:
-
Contact First Name:
Last Name:
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
Postal Code:
Contact First Name:
Last Name:
Phone:
-
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
Postal Code:
Contact First Name:
Last Name:
Phone:
-
How would you like to receive your monthly statement? (please check one)
email
mailed
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