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                                    Advanced Commercial Credit International (ACI) Limited

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Application for Business Financing and Equipment Leasing

By clicking on the "SUBMIT Query" Button at the bottom of the application, I accept, authorize and request that  Advanced Commercial Credit International (ACI) Limited, and/or it's assigns, to release to, and obtain from, credit reporting agencies, assigns, and other third parties, any and all credit, personal and business information, regarding the information contained in this application, and for information gathered not included in this application, and this authorization also includes credit checks.

When finished, after you click on the "SUBMIT Query" Button at the bottom of the page, a representative from ACI will contact you.




Advanced Commercial Credit International (ACI) Limited



Suite #300, 1600 Bedford Highway

Bedford, NS Canada B4E1E8

Telephone: (902) 405-4003

Toll Free: (888) 755-8355

Fax: (902) 484-7081


First Name



Last Name



Email Address



Home Address









Zip/Postal Code






Home Telephone Number



Home Fax Number (Or Other Fax Contact Number)



Date of Birth



SSN / SIN Number



Marital Status



Number of Dependants (Excluding Spouse)






Since What Month and Year



Can We Confirm Your Employment?



Employer Telephone Number



Bank Name



Bank Address



How Long (Years)



Bank Telephone Number



Your Gross Monthly Income



Spouse/Other Monthly Income



Average Monthly Chequing Balance



Average Monthly Savings Balance



Cash in Chequing Accounts



Cash in Savings Accounts



GIC's and Term Deposits



Notes/Amounts Due to You From Others



Life Insurance (Cash Value)



Stocks and Bonds



Real Estate - Market Value



Vehicles - Market Value



Value of Retirement Plans



Other Assets



Mortgages Owed



Mortgage Monthly Payment



Credit Cards Total Owed



Credit Card Monthly Payments



Total Bank Loans



Total Bank Loans Monthly Payments



Other Credit Facilities Total Owed



Total Other Credit Facilities Monthly Payments



Total Taxes Owed



Have you Guaranteed Any One Else's Debts? (Provide Details)



Have You Ever Declared Personal Bankruptcy? If Yes When? (Provide Details)



Are There Any Legal Judgments Against You or Legal Suits Pending or On-Going?( If Yes, Provide Details)






Your Business Name



Type of Business



Business Address












Business Telephone Number



Business Fax Number



Date Business Established



Federal Business Tax Number



Average Business Cash Balances



Principal 1 Name



Principal 1 Address



Principal 1 City



Principal 1 State/Province



Principal 1 Zip/Postal Code



Principal 1 SSN/SIN



Principal 2 Name



Principal 2 Address



Principal 2 City



Principal 2 State/Province



Principal 2 ZIP/Postal Code



Principal 2 SSN/SIN



Business Bank Name



Business Bank Address



Length of Time With Current Bank (Years)



Business Bank Account Number



Business Bank Telephone Number



Business Bank Contact Person



Trade Reference 1 Name



Trade Reference 1 City



Trade Reference 1 State/Province



Trade Reference 1 Account #



Trade Reference 1 Telephone Number



Trade Reference 1 Contact Name



Trade Reference 2 Name



Trade Reference 2 City



Trade Reference 2 State/Province



Trade Reference 2 Account #



Trade 2 Reference Telephone Number



Trade 2 Reference Contact Name



Trade 2 Reference Telephone Number



Can We Do A Personal Credit Check On You?



Can We Discuss Your Personal and Business Affairs With Potential Lenders?



Please Describe Your Financing Request.



Total Value Of Business Assets From Financial Statements



Total Business Liabilities From Financial Statements



Total Retained Earnings





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Last modified: 01/24/11