CREDIT APPLICATION

CORPORATE INFORMATION

Legal Name*
Company Name – Operating Name (dba or o/a)* (if different from above)

Address*
City*
Province*
Postal Code*
Telephone*
Fax
Business Description*
Year of Incorporation*

OWNER(S) | PARTNER(S) | OFFICER(S)
Name*
Title*
Address*

Name
Title
Address

Name
Title
Address

ACCOUNTS PAYABLE CONTACT
Name*
Title*
Phone*
Email*

BANK REFERENCE
Bank Name*
Acct#*
Address*
Branch*
Phone*
Contact Name*

TRADE REFERENCES (FUEL & TIRE COMPANIES NOT ACCEPTED)
Company Name*
Contact Name*
Email*
Phone#*

Acceptable file types doc, docx, pdf, jpg, jpeg, png, gif, zip- 10MB Max

Company Name*
Contact Name*
Email*
Phone#*

Company Name*
Contact Name*
Email*
Phone#*

Additional Comments


DOCUMENTS REQUIRED FOR TRAILER RENTAL:
1) CVOR

Acceptable file types doc, docx, pdf, jpg, jpeg, png, gif, zip- 10MB Max
2) PROOF OF INSURANCE
MUST SHOW 3rd PARTY LIABILITY @ $2M* with Breadner named.

Acceptable file types doc, docx, pdf, jpg, jpeg, png, gif, zip- 10MB Max

THE ABOVE DOCUMENTS MUST BE RECEIVED PRIOR TO TRAILER PICK-UP.

The undersigned consents to the obtaining of such information as R&S TRAILER LEASING LIMITED may require at any time in connection with the credit hereby applied for, any renewal thereof and to the disclosure of any information concerning the undersigned to any credit reporting agency or to any person with whom the undersigned has or proposes to have financial relations.

Signature:
Title:
Date: