Flex Fast Track

VENDOR

Equipment Description

Sales Rep

Phone Number

Equipment Cost $

Lease Term Requested (in months)

APPLICANT

Name

DOB

SIN (optional)

Home Address

City/Province

Postal Code

Home #

Cell #

Email Address

The undersigned certifies the above information to be true and correct and hereby authorizes and instructs Weslease of Canada Ltd., its nominee or any person, credit agency or credit grantor to compile, furnish and disclose such information as may be required to approve the credit applied for herein. The equipment to be financed is intended for business or professional use and under no circumstances is this to be considered an application for consumer financing.

Authorization

Name

Date