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ON-LINE CREDIT APPLICATION

Please enter all information below, it only takes 2 minutes to complete.

COMPANY INFORMATION

Years in business
Industry
Province of Registration
Are Corporate taxes up to date?
Type of business

PERSONAL INFORMATION (Principal)

Province of Residency
Home Ownership
Years at Address
Birthday
Year
Month
Day
Are your personal taxes up to date?
Prior Bankruptcy?

TRANSACTION DETAILS

Reason for credit request
Repayment Term requested
How were you referred to Coventry?

Credit Investigation and Disclosure of Personal Information

Company and Principal are collectively called ("Customer"). Customer hereby consents to Coventry Credit D/O Summit Funding Corporation ("Coventry") conducting a personal credit investigation and or credit check upon Company and Principal for the express purpose of determining Customer’s credit worthiness, subject to applicable legislation. Customer hereby warrants all the information to be true and accurate and Coventry reserves the right to confirmation of information at any time. Customer hereby consents to the transfer of the Customer’s personal information by Coventry to any assignees or other parties acquiring the agreement or interests in the agreement or entering into arrangements with respects to the agreement. Customer hereby consents to the transfer of his/her personal information to any purchaser of Coventry or its business or as required during the term of the Agreement. Please see our Privacy page regarding how your Company and Personal information is managed by Coventry.

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