BUSINESS CREDIT APPLICATION - Acura

[Pages:2]DEALER TO

COMPLETE

Dealer Number

NEW / DEMO USED

Dealer Name

BUSINESS CREDIT APPLICATION

LEASE

GRADUATE PROGRAM

CONDITIONAL SALE

FUTURE VALUE PURCHASE PROGRAM

Year

Make

APPLICANT CO-APPLICANT

Model Code

PLEASE PRINT

Name of Company/Firm

Current Address

Number and Street

Unit Number

City

Province/Territory

Postal Code

Business Phone Number

Number of Years

Previous Address (If less than 3 years at Current Address)

Number of Years

Nature of Business

Years in Business

Please Check One of the Following:

Corporation

Partnership

Proprietorship

Jurisdiction of Incorporation

Date of Incorporation

Name and Address of Parent Corporation

Number and Street

Unit Number

City

Province/Territory

Postal Code Business Phone Number

Officers and Principals

Full Legal Name Home Address Number and Street Apt. Number City Province/Territory Postal Code Home Phone Number

Title

Full Legal Name Home Address Number and Street Apt. Number City Province/Territory Postal Code Home Phone Number

Title

Banking Information

Name of Institution

Branch

Contact Name

Phone Number

Account Number

Check if Authorized to Borrow

Check if Authorized to Borrow

Type of Account

Date Opened

Name of Institution

Creditors

Name

Branch Address

Contact Name Number and Street

Phone Number

Account Number

Type of Account

Date Opened

City

Province/Territory

Postal Code

Phone Number

Name

Address

Number and Street

Principal Driver

Name

Home Address Number and Street

Apt. Number

City

Position

City

Province/Territory

Postal Code

Phone Number

Province/Territory

Postal Code Home Phone Number

Driver's Licence Number

Date of Birth MM DD YY

Percent of Driving %

The Acknowledgement and Consent on the reverse side and this business credit application shall be considered one document.

The undersigned warrants that the information provided in this business credit application is true, complete and correct.

Authorized Signatory of Business Applicant Authorized Signatory of Business Applicant

Name and Title (Please Print) Name and Title (Please Print)

Date Date

HCFI (03/05) BCA 1004-E PQ

SEE OVERLEAF

ACKNOWLEDGEMENT AND CONSENT FOR BUSINESSES

Name of Business Applicant:

Address:

To the extent applicable under the relevant legislation: You may have certain legal rights relating to the personal information provided to us when you apply for credit from Honda Canada Finance Inc. ("HCFI"). This document sets out your rights relating to the privacy of the information provided to us when you apply for credit from HCFI and any other information provided to us subsequently in connection with the application for credit and any credit granted. Once we receive your application for credit, we will open a file on you. The purposes for opening a file on you are to:

? evaluate your application and your eligibility for credit; ? assess your solvency; and ? decide whether you are approved for a conditional sales agreement or a lease agreement for a vehicle. If you are approved and you enter into such an agreement with us, we will also use this information for contract management and marketing purposes. Contract management includes notably credit, billing, collection, lien registration, insurance tracking and service and warranty purposes. Marketing includes the marketing and promotion of products, goods and services which we believe may be of interest to you. We will maintain your file for as long as we have a business relationship with you. Once our business relationship with you has ended, we and the Dealer (as defined below) may still use your identification details (such as your business name, address(es) and telephone number(s)) only for marketing purposes. Please initial the box below if you do not want your personal information used for marketing purposes.

I disagree:

The information contained in your file will be used for the purposes stated above.

Certain of our employees (including those of our Canadian and foreign subsidiaries and affiliates), agents and contractors as well as the authorized dealer named in the business credit application (see reverse side) or any other authorized dealer(s) designated by us (the "Dealer") will have access to your file while we maintain it. Said persons will be limited to those who require the information contained in your file as part of their functions and mandates and such access will be limited for the purposes outlined in this Acknowledgement and Consent. Your file will be kept at our branch office located at 1750, Eiffel Street, Longueuil (Boucherville), Province of Quebec, J4B 7W1, telephone no.: (450) 641-9062.

You also acknowledge and consent that the information contained in your file will be transferred to a third party or parties for the same purposes and duration outlined in this Acknowledgement and Consent if said conditional sales agreement or lease agreement is transferred or assigned to such third party or parties, or to an organization in connection with the due diligence for, and completion of, a business transaction, including, without limitation, a securitization or financing involving HCFI or its subsidiaries or affiliates.

If you request, we will give you access to the information contained in your file. You can review your information and correct any information that is inaccurate, incomplete or unclear. You can also ask us to delete any information which is obsolete, unjustified or has been obtained illegally.

To obtain access to your file, please write to us and we will arrange an appointment for you to visit our branch office in Boucherville.

To evaluate your eligibility for credit, we and the Dealer may contact a credit reporting agency and obtain your credit report. We and the Dealer may also contact the financial institutions listed in the business credit application (see reverse side) and credit report to obtain additional credit information on you.

You consent to the information contained in your file being exchanged with a credit reporting agency, financial institutions and other third parties, but only for the objects outlined above, and only if they have legitimate reasons for handling it. Signing this Acknowledgement and Consent means that you authorize us as well as those who work for us or with us (including our Canadian and foreign subsidiaries, affiliates, agents and contractors) and the Dealer to obtain necessary information and exchange it with third parties for the purposes outlined in this Acknowledgement and Consent.

You can access a copy of your credit report from the following credit reporting agency:

Equifax Canada Inc. 7171 Jean-Talon East Montr?al, (Qu?bec) H1M 3M2 Telephone : (514) 493-2470

You can also ask Equifax to correct any information which is inaccurate.

The business credit application on the reverse side and this Acknowledgement and Consent shall be considered one document. Reference to business credit application or credit application in any related documents shall include this Acknowledgement and Consent. It is the express wish of the parties that this form and any related documents be drawn up and executed in English. Les parties ont express?ment exig? que le pr?sent formulaire et tous les documents s'y rattachant soient r?dig?s en anglais.

I CONFIRM THAT I HAVE RECEIVED A COPY OF THIS DOCUMENT AND THAT I HAVE READ AND UNDERSTAND ITS CONTENTS. I ALLOW HONDA CANADA FINANCE INC. TO OPEN A FILE ON ME AND TO OBTAIN AND EXCHANGE INFORMATION IN THAT FILE AS INDICATED ABOVE.

Authorized Signatory of Business Applicant Authorized Signatory of Business Applicant

HCFI (03/05) BAC 1006-E PQ

Name and Title (Please Print) Name and Title (Please Print)

SEE OVERLEAF

Date Date

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download