Contact
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Applicant
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Fax: *
Company: Proprietor Partnership Corporation*
Property:   Owned        Leased* 
Years in business: *
Average # of employees: *

Principles

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Trade References

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Credit
Anticipated Monthly Purchases: CND $*
Credit Requested: CND $*

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I certify the above information to be true and correct. The undersigned consent to the obtaining of such information by Cancore Industries Inc. or Hamilton Radiator Service Ltd. from any credit reporting agency or other source as Cancore Industries Inc. or Hamilton Radiator Service Ltd. may require at any time in connection with the credit hereby applied for or any renewal or extension thereof and to the disclosure of any information concerning the undersigned to any credit reporting agency or to any person with whom the undersigned has or proposes to have financial relations. Please advise Cancore Industries Inc. or Hamilton Radiator Service Ltd. of any business status changes.
 

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