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Basic Information
Additional Information
Summary
Basic Information
How did you hear about us?
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Referred by a representative of our company
Referred by a Manufacturer
Referred by another Dealer
Received notification letter with reference code
Other
Dealership Information
Legal Name of Business
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Business Type
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Individual/Proprietorship
Corporation
General Partnership
Limited Partnership
LLC - Member Managed
LLC - Manager Managed
Primary Market
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Agricultural
Golf & Turf
Food Processing
Name of Business
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Province of Incorporation
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Alberta
British Columbia
Manitoba
Nouveau-Brunswick
Newfoundland
Territoires du nord-ouest
Nouvelle-Écosse
Ontario
Île-du-Prince-Édouard
Québec
Saskatchewan
Territoires du Yukon
Fiscal Year End
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January
February
March
April
May
June
July
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December
Please Enter all Dates in MM/DD/YYYY Format.
Date When Incorporated
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Years In Business
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Date Business Started
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Business Jurisdiction
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Federal
Provincial
Date Business Acquired
Requested Credit Limit
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Company's Identification Information (If Available)
Tax Registration Number
Corporate Number
Name(s) of Business
Inventory to be Financed
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Competitors in the Market
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Estimated market share by product line
Product
Share %
Action
Product
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Share %
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Required Fields
Add
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Which major manufacturer lines do you carry?
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Were you recommended to apply by a manufacturer?
If so, please enter the name of the manufacturer here
Applying for?
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Inventory Financing
Retail Financing
List Other Businesses
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Have there been any recent ownership changes or are any planned?
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Yes
No
Current ownership duration
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Address
Business Physical Address
Street
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City
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Province
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AB
BC
MB
NB
NF
NL
NW
NS
ON
PE
QC
SK
YK
Postal Code
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Business Mailing Address
Street
City
Province
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AB
BC
MB
NB
NF
NL
NW
NS
ON
PE
QC
SK
YK
Postal Code
Mailing address is the same as the physical address
Contact Information
Contact Name
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Email Address
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Office Phone Number
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Mobile Phone Number
Fax Number
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Website
Other Information
Is there a wholesale funding facilities in existance?
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Yes
No
Is there an operating line of credit with a financial institution?
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Yes
No
Has applicant, officer, or member been bankrupt?
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Yes
No
Has applicant, officer, or member thereof ever made a proposal to creditors for payment less than amount due?
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Yes
No
Are all taxes and remittances paid up to date?
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Yes
No
Prior Dealings with De Lage Landen Financial Services Canada Inc. or affilates under this or any other name?
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Yes
No
Last 3 years' FYE financial statements (Interim statements if FYE more than 6 months old, with prior year same period comparatives)
Copy of Articles of Incorporation to verify corporate name and officers (or copy of birth certificate and business registration if proprietorship / partnership)
Personal Financial Statement(s) for ALL shareholders or if business is a Sole Proprietorship please provide personal tax form.
If in business less than 1 year, Opening Balance Sheet and Business Plan with projections.
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Required Fields
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