COMMERCIAL LEASING APPLICATION
PRINCIPAL
VENDOR AND EQUIPMENT

Leaseline is a trade name of LeaseLine Financial Services Corp. (herein "Leaseline"). The undersigned certifies to Leaseline that the above information, as well as any other information provided to Leaseline or its agents from time to time, is true and correct and may be used in connection with this credit application and any subsequent lease arrangement. Moreover, the undersigned authorizes and consents to Leaseline's collection, use and disclosure of any such information in accordance with its Privacy Policy.

Your LeaseLine Representative, Randy Mosicki 203 - 540 Lawrence Avenue, Kelowna, BC V1Y 6L8 Phone: 250-448-7400, ext 109 / 1-800-288-7875 Direct: 250-448-7405 www.leaseline.com
PERSONAL NET WORTH STATEMENT
ASSETS VALUE LIABILITIES AMOUNT OWING

CASH & INVESTMENTS VALUE

CREDIT CARDS AMOUNT OWING

1.
2.
3.
4.

BUSINESS ASSETS VALUE

BUSINESS LIABILITIES AMOUNT OWING

VEHICLES VALUE

1.
2.

VEHICLE DEBT AMOUNT OWING

1.
2.

REAL ESTATE VALUE

1.
2.

MORTGAGE DEBT AMOUNT OWING

1.
2.

OTHER ASSETS VALUE

1.
2.

OTHER DEBT AMOUNT OWING

1.
2.
TOTAL ASSETS
TOTAL LIABILITIES

Leaseline is a trade name of LeaseLine Financial Services Corp. The undersigned certifies that the above information is true and correct and authorizes Leaseline to collect, use and disclose personal information for credit assessment, financing and related purposes in accordance with its privacy policy.

LeaseLine Equipment and Vehicle Leasing, 203 - 540 Lawrence Avenue, Kelowna, BC V1Y 6L8