Personal Credit Application (Home):: McDougall Energy

Personal Credit Application (Home)

Required Field

Applicant's Information

Co-applicant's Information

Applicant’s Full Legal Name (hereinafter known as applicant):

Title:		First Name:
Middle Initial:		Last Name:
Email:
Date of Birth:		S.I.N.:
	(mm/dd/yyyy)

Co-applicant’s Full Legal Name:

Title:		First Name:
Middle Initial:		Last Name:
Email:
Date of Birth:		S.I.N.:
	(mm/dd/yyyy)

Principal Residence

Principal Residence:	Address 1:	Address 2:	City:	Prov:	Postal Code:
	Home Phone: - Work Phone: - Cell Phone: -
	Years at current address:


Own:	Mortgage provider:	City:
Rent:	Landlord's name:	Phone:	-

Delivery Address:

Same as above:

Address 1:	Address 2:	City:
(if different from address above)
Prov.: Postal Code:

Previous Address:	Address 1:	Address 2:	City:
	(if less than three years at current address)
	Prov.: Postal Code:

Applicant's Employer

Co-applicant's Employer


Present Employer:
Position:
Phone:	-
	How long there?
Previous Employer:
	(if less than three years at current job)
	How long there?


Present Employer:
Position:
Phone:	-
	How long there?
Previous Employer:
	(if less than three years at current job)
	How long there?

More Information

Your Current Financial Institution:		Branch:
Yes, I have chosen 'Automatic Delivery' and yes I am aware of the terms and conditions of the 'No Run Out Program'. (OAC)
Yes, I have been offered the Worry Free Service Plan and at this time I do not wish to purchase it.
How would you like to receive your monthly statement? (please check one) emailmailed

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 the equipment financing entity Community First Credit Union Limited (CFCU) to conduct credit history checks for the purposes of credit approval.

For MEI only: 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 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