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Big News! All 2011 KYMCO UXV 500 Side by Sides, and 2011 KYMCO MXU 500 IRS Atv's now have fuel injection. Price, quality, and value. That's KYMCO. " Better Than Best"

Credit Application

Company Information as Applicable
Legal Name Corporation #
Trade Name Phone
Address Fax
City Postal Code
Prov
Contact Position
Type of Business Years in Business
Contact
Insurance broker Telephone
Owner / Partner / Personal Information as Applicable
Name Phone
Address Cell
City Postal Code
Prov
Occupation Employer
SIN How long employed
Date of Birth Gross monthly income
Banking Information
Bank Contact Name
Address Postal Code
Account number Prov
Phone Fax
Trade References
Company Address
Contact Fax


Phone
Company Address
Contact Fax


Phone
Company Address
Contact
Fax


Phone
Other Information
PST exemption # GST exemption #
A/P contact Telephone
Reason for seeking credit Rental Parts Service Equipment Lease Other
Purchase order required Yes No
Amount of credit requested
You confirm that the information you have given us in respect of this application is true and complete, and you authorize us to rely on and use this information in order to confirm your identitiy, evaluate your credit worthiness, in relation to the credit being sought.In particular, you agree that we, our affiliates and any third parties acting for us or on our behalf (hereinafter collectively "us", "we" or "our"), may obtain a credit report or other credit information from any credit reporting agency, credit bureau or credit grantor, and may hold, use, exchange and disclose such information for the purposes of transacting business with .If your application is approved, you authorize us to collect , hold use, exchange anddisclose your personal information, as required, in order to administer, service or enforce any lease, ancillary deed or transaction including but not limited to assignments and securitizations.We will keep a file containing some or all of your personal information at the offices ofYou have the general right to access and rectify the personal information in this file by making a written request to our offices.Terms Net in 30 days,accounts overdue may have a S/C applied and may be placed on credit hold.If there is a defaultcollection fees will be the responsiblility of the customer.
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