Bus. Name:
Incorporated?
Yes
No
Street:
City:
Prov:
Postal Code:
Phone:
Fax:
E-mail:
Type of Bus.:
Established:
Trade Name:
Reg. At:
President/Partner:
% Owned:
Own/Rent:
Own
Rent
Street:
City:
Prov:
Postal Code:
Phone:
Soc. Ins. No:
Secr./Treas.:
% Owned:
Own/Rent:
Own
Rent
Street:
City:
Prov:
Postal Code:
Phone:
Soc. Ins. No:
Fed. & Prov. Taxes:
Are you current?
Yes
No
Arrears:
Period:
Empl. Deductions:
Are you current?
Yes
No
Arrears:
Period:
Company Bank:
Street:
City:
Prov:
Account:
How Long:
Yr./Mo.
Bank Officer:
Phone:
Receivable:
Total Now Open
Avg. Monthly Sales:
Active Customers:
Approximate Number
Terms of Sale:
Discounting Receivable:
No
Yes, Now
Yes, In the Past
If Yes, to Which Company?:
Receivable Pledged as Collateral:
No
Yes
If Yes, to Which Company?:
Projected Sales:
/Mo.
