Application

Step 1 of 6

Main Applicant Information

Name*

First Last

Date of Birth*

Email*

Home Phone*

Cell Phone

Address*

Street Address Address Line 2 City Province Postal Code

Social Insurance Number*

Driver's License Number*

Do you own or rent your home?*

How long have you lived at your current address?*

Previous Address (If you have lived at your current address for less than two years)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Have you ever filed bankruptcy or a consumer proposal?*

If yes, when did you file bankruptcy / consumer proposal?*

If yes provide details about your bankruptcy or consumer proposal (type, status, etc.)*

Have you ever had a vehicle repossessed?*

If yes, when and why?*

Do you have any "Pay Day" loans?*

If yes, how much do you owe?*

Employment / Business Information

Are you the Owner / Operator?*

Are you Self Employed?*

Employer / Broker Name*

Length of Employment*

Employer Contact Name*

Employer Phone Number

How many years have you been an owner/operator?*

How many years have you been a Class 8 Driver?*

If you own a Company, what is the name?

Date Business Established?*

Sole Proprietor or Incorporation?

Business or Incorporation Number

Does the business use an operating or trading name?*

What is your Fiscal Year End?

If yes, what is the name?*

Operating Authorities held by Applicant*

(i.e. plates & insurance)

Held by Employer/Broker*

Do you own, lease or operate any other commercial vehicles?*

If yes, how many?*

Are any of your assets currently pledged as collateral*

If yes, to whom?*

Is it under a General Security Agreement (GSA)?*

Are you current with your remittances to the CRA for the following:

Personal Taxes*

Corporate Taxes*

Source Remittances*

GST/HST Filings*

If you answered No to any of the above is there an arrangement in place with the CRA?*

What are the balances due?*

Are you willing to provide copies of your notice of assessments (NOA) to support the above?*

Personal Reference

Personal Reference Name*

First Last

Phone*

Vehicle Information

Year*

Make*

Model*

Vehicle's VIN*

Estimate Acquisition Cost*

Mileage in Kilometres*

What type of financing are you interested in?*

Dealer / Repairer Information

Referring Repairer / Dealer*

Dealer Contact Name*

Phone*

How did you hear about Global Leasing Group or EZ Repair Loan?

Personal Net Worth Statement

Assets

Cash on Hand*

Real Estate*

Investments - Stocks & Bonds*

Life Insurance - Attach Details*

Vehicles (specify)*

Other Assets*

Total Assets*

Liabilities

Mortgage*

Loan (Specify)*

Line of Credit (Specify)*

Credit Card (Specify)*

Income Tax Unpaid*

Property Tax Unpaid*

Other Liabilities (List Below)*

Total Liabilities*

Net Worth*

Gross Annual Income

Salary, Wages, Commissions etc.*

Business or Professional Income*

Rental Income*

Dividends & Interest*

Other Income (specify)*

Total Gross Income*

Annual Expenditures

Property Taxes*

Income Taxes*

Loan Payments*

Mortgage Payments*

Insurance Payments*

Payments on Charge Accounts*

Estimated Living Expenses*

Other*

Total Expenditures*

Net Disposable Income*

Optional Documents

Submitting these documents is optional, but having them will help us process your application more quickly.

Information to follow for Initial Approval:

To accompany loan application for Initial Approval:

Completed Loan Application
Copy of Vehicle Ownership
Proof of Insurance (Copy of Certificate)
Copy of Debtor’s Driver’s License
Copy of Dealer estimate or quote

Information to follow for Final Approval:

Copy of Lease Agreement (if applicable)
Copy of Articles of Incorporation and/or Business Registration (if applicable)
Copy of Broker Agreement or Transportation Authorities (if applicable)
2nd Piece of identification i.e. Citizenship, Birth Certificate, Passport or Social Insurance Number (SIN)
Proof of wage/income and Financial or Bank Statements
Void Cheque (for pre-authorized payments)
Copy of Final Dealer invoice signed by owner

File

Drop files here or

Max. file size: 20 MB, Max. files: 20.

Acknowledgement*

The above statements in this application are true and accurate to the best of my information and belief. I have the authority to bind the Company and this serves as my permission for the release of any information regarding this application for the purpose of both personal or corporate credit investigation. I acknowledge and consent to the collection and use of personal information in this application by Global Leasing Group Ltd. in connection with the granting or consideration of credit including credit reportin g agencies. I agree to the privacy statement and terms and conditions outlined on the Global Leasing Group Ltd. website www.globalleasinggroup.com. I acknowledge that the provision of incorrect information or the misrepresentation of any information provided on this form will result in Global Leasing Group Ltd. withdrawing any offer of financing.

I certify that all the information I've provided is correct.

Date*

Other Shareholders & Officers

If different from main applicant, if more than one please attach additional pages.

Is there business partner information you'd like to submit?*

Partner Name*

First Last

Partner Date of Birth*

Address*

Street Address Address Line 2 City Province Postal Code

Partner Social Insurance Number*

Partner Driver's License Number*

Date*

Comments

This field is for validation purposes and should be left unchanged.

Application

Main Applicant Information

Employment / Business Information

Personal Reference

Vehicle Information

Dealer / Repairer Information

Personal Net Worth Statement

Assets

Liabilities

Gross Annual Income

Annual Expenditures

Optional Documents

Information to follow for Initial Approval:

Information to follow for Final Approval:

Other Shareholders & Officers

Site Map

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Main Applicant Information

Employment / Business Information

Personal Reference

Vehicle Information

Dealer / Repairer Information

Personal Net Worth Statement

Assets

Liabilities

Gross Annual Income

Annual Expenditures

Optional Documents

Information to follow for Initial Approval:

Information to follow for Final Approval:

Other Shareholders & Officers

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