North American Lease Underwriters Inc
#200 2030 Marine Drive, North Vancouver, B.C. V7P 1V7 . . Fax: (604) 980-4345

Consumer Lease Application Form

How to submit this application form:.
1.
2.
3.
Print out blank form
Complete and sign
Send by fax or mail


Personal Information
Last Name
First Name
Initials
Address
City
Province
Postal Code
Phone
Own/Rent/Other
How Long
Date of Birth
# of dependents
Social Insurance #
Previous Address
How long

About My Work
Employer Name
Employer Address
Gross Annual Income/Salary
Work status
.

Full Time, Part Time, Self Employed, Retired, Student
# of years with present employer
Current Position/Title
Former Employer
Address
Previous Position/Title

About My Spouse
Spouse's Last Name
First Name
Initials
Spouse's Employer
Gross Annual Income/Salary
Work status
.

Full Time, Part Time, Self Employed, Retired, Student
# of years with present employer
Current Position/Title

About My Finances
Other Monthly Income
Sources of Other Income
Monthly Mortgage/Rent Payments
Estimated Value of Real Estate
Bank
Branch
Acct #

Equipment Information
Equipment Type
Equipment Cost
Vendor Term
Representative


The undersigned certifies the above information to be true and correct by signing below. We consent to North American Lease Underwriters Inc. obtaining from any credit reporting agency of credit grantor, such information as it may require at any time in connection with the credit hereby applied for, and consent to the disclosure at any time of any information concerning the undersigned to any credit reporting agency or to any credit grantor with whom the undersigned has financial relations.



Signature of Applicant


Signature of Co-Applicant



Date
Color

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