Lease new and used restaurant and refrigeration equipment

Lessee Information

Legal Name :

Address :

Email :

Phone :

Contact :

Start Date :

No. of Empl. :

Type of Business :

Equipment Details :

Cost :

Down :

Trade :

CLBO :

Vendor :

Contact :

Term :

Bank :

Account # :

Branch :

Bank Phone :

Bank Contact :

Fax :

Owner's Name :

Home Phone :

Home Address :

Own :

Rent :

Date of Birth :

Social Insur. # :

ACKNOWLEDGEMENT: By signing below the Applicant and/or User confirms that the Business, Principals, Co-Applicant, Co-Lessee or Guarantor have consented to:

The collection, use and disclosure of personal (or Business) Information for the purpose of credit adjudication by ARCTIC and/or its funders (lessors, banks, credit unions & insurance companies) in order to provide the applicant with the lease, loan, mortgage or financing requested.
ARCTIC and /or its funders to obtain credit information including consumer/commercial reports from consumer/commercial reporting agencies, financial institutions and any other references, provided by the applicant in connection with this application. A facsimile or electronic signature shall be accepted as an original execution.
Social Insurance Numbers being used as an aid to identify you with the consumer credit reporting agency and/or funders for credit history file matching purposes.
ARCTIC and/or its funders to disclose Personal (or Business) Information in connection with the proposed financing to ARCTIC subsidiary companies, funders, credit reporting agencies, or other parties that the applicant may have financial dealings as well as ARCTIC using said information to promote our services to you.

I Agree :

Date :

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