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Commerical Credit Application

Financing Request
$
Enter a value with no spaces.
General Business Information
(choose one)
Business Ownership
Names of Principal Owners% of Ownership
At least one principal owner is required.
Accountant/Bookkeeper
Please tell us about yourself
When you first started at current employer


If applicable, please expand section and fill in spousal information.
Please tell us about your PERSONAL income
Enter a number value with no spaces. Decimals are allowed.
$
$
Leave at 0 if not applicable
$
Leave at 0 if not applicable
$
$
{employment_income} + {spouses_employment_income} + {family_allowance_child_tax_credit} + {rental_income_net} + {other_income}

Please tell us about your PERSONAL assets and liabilities



ASSETS
Enter a number value with no spaces. Decimals are allowed.

Name and Address of Financial InstitutionTypeAccount #MaturityInterest RateAmount
$
DescriptionRegistered Owner# of shares/unitesPar valueMarket value
$
Name and Address of Financial InstitutionType of planAdditional detailsAmount
$
CompanyPolicy dateFace amountBeneficiaryCash surrender value (CSV)Policy loansNet CSV
$
AddressDescriptionNo. of unitsDate aquiredCostMarket value
$
DescriptionYearMakeModelOriginal CostOtherMarket Value
$
Please Provide Detailed DescriptionMarket Value
$
{schedule1sum} + {schedule2sum} + {schedule3sum} + {schedule4sum} + {schedule5sum} + {schedule6sum} + {schedule7sum}


LIABILITIES
Enter a number value with no spaces. Decimals are allowed.

Name of Financial InstitutionTypeOriginal Amount/LimitPurpose & CollateralInterest RateMonthly PaymentAmount Outstanding
$
$
$
$
{schedule8sum} + {unpaid_income_taxes} + {unpaid_property_taxes} + {other_debts}
({schedule1sum} + {schedule2sum} + {schedule3sum} + {schedule4sum} + {schedule5sum} + {schedule6sum} + {schedule7sum}) - ({schedule8sum} + {unpaid_income_taxes} + {unpaid_property_taxes} + {other_debts})
$


Guarantees and Indirect Financial Commitments

DescriptionAmountFor the Benefit of
General Information
Please provide details if you answer yes to any of the following questions.
Details of repossessed assets
Bankruptcy details
Claims/lawsuit details
Tax information details

Declaration and Authorization
The undersigned declare(s) that the statements made herein are for the purpose of obtaining financing and are to the best of my/our knowledge true and correct. The applicant(s) consent to Parama Credit Union making any inquiries it deems necessary to reach a decision on any credit application, associated with information in this personal financial statement, and consent(s) to the disclosure at any time of any credit information about me/us to any credit reporting agency or to any one with whom I/we have financial relations.
Authorized Signature
The undersigned certifies that all the information in this form is accurate and complete and consents to Parama Credit Union ("PARAMA") obtaining personal and commercial credit information, or any related information that PARAMA may require at any time in connection with the credit hereby applied for or any renewal or extension thereof and further consents to the disclosure of any information to any credit reporting agency or to others.
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