APPLICATION FOR FINANCING
1. THE APPLICANT: Telephone
Principal place of business at:
(Street Address) (Town/City) (Province) (Postal Code)
(Telephone Number) (Fax Number) (Email Address)  
2. CARRYING ON THE BUSINESS OF:
3. HEREBY APPLIES TO BRUCE COMMUNITY FUTURES DEVELOPMENT CORPORATION (the "Corporation")
for financing of $ under the following project to be financed:
ESTIMATED PROJECT COSTS EXPECTED FINANCING
Land $ CFDC Loan $
Building/Leaseholds $ Investment by Owners $
Equipment $ Other Financing $
Working Capital $ Grants $
$ $
TOTAL $ TOTAL $
4. AND MAKES THE FOLLOWING STATEMENTS:
(a) That the Applicant's business was established
(b) As Corporation Partnership Proprietorship Other
(c) That the Officers and shareholders of the Applicant's business are:
 
Full name Address Position/Office
% Interest
Years Within Firm
(d) That a partnership agreement was executed and is attached:
  Yes No
  If yes, please enter the date of partnership and attach agreement below:
  Date of Partnership:          Partnership Agreement:
  *Note: Each partner is required to complete a Statement of Personal Assets & Liabilities with this application.
(e) That this project is expected to influence the following:
  New Jobs Jobs Maintained
(f) That conventional financing was unavailable for this business proposal: Yes No
(g) That the Applicant will notify the Corporation immediately of an application pending and under consideration by
another lender, or if negotiations are entered into, or an offer of financing is received, during the period of the
Corporation's consideration of this application.
(h) That the Applicant carries a bank account(s) at:
 
  (Name of Bank) (Address of Bank)
 
  (Name of Bank) (Address of Bank)
  and will instruct the bank(s) to give the Corporation full information concerning the Applicant's affairs.
(i) That there has been no material adverse change in the financial position or operations of the Applicant
since being the end of the last fiscal year of the Applicant for which a balance sheet and a profit
and loss statement have been furnished.
(j) That there is no litigation in course or threatened, nor any proceedings before any court, tribunal, governmental
board of agency now in course or threatened, and that there is no unexecuted judgment rendered against
the Applicant, except:
 
  (Litigation/proceedings involving the Applicant and/or any close related individual or corporation should be reported.)
5. THE APPLICANT UNDERSTANDS AND AGREES:
(a) That the Applicant will be responsible for payment of all charges relative to preparation, execution and registration
of such documents as may be required by the Corporation or its solicitors.
(b) That the terms and conditions of any financing which may be authorized will be set forth in a Letter of Offer, for
agreement and acceptance by the Applicant;
(c) That the statements made herein are for the express purpose of obtaining financing from the Corporation and
are to the best of the Applicant's knowledge and belief true and correct. The Applicant understands that additional
information in support of this application must be supplied to the Corporation, if requested, before adequate
consideration can be given to this application. The Applicant realizes that any present or future indebtedness
of the Applicant, or the Applicant's business, to the Corporation may become due and payable if any
information provided by the Applicant to the Corporation proves to be inaccurate or incomplete;
(d) That in applying for this financing and, in the event that the Corporation approves such application,
the Applicant's personal and confidential business information will be requested from the Applicant
and/or collected from third parties that have information about the Applicant's business and personal
financial status for the purposes of determining the Applicant's eligibility for financing and
reporting to Industry Canada.
6. DISCLOSURE, RELEASE AND WAIVER OF LIABILITY
(a) The Applicant acknowledges that he or she approached the Corporation to obtain information about business and has, or is preparing a business plan.
(b) The Applicant acknowledges that he or she is solely responsible for the success or failure of his/her
business, and that any information which is provided to the Applicant by representatives of the
Corporation is for the Applicant's understanding only. It is the Applicant's responsibility to verify
the accuracy of such information or to seek additional information concerning any aspects of the
Applicant's proposed business.
(c) The Applicant further agrees to hold the Corporation harmless and hereby releases and discharges
the Corporation from any actions, damages, claims or demands which may arise, directly or indirectly,
as a result of any act or omission by the Corporation in providing information to the Applicant, and to
indemnify the Corporation from any such actions, damages, claims or demands which might be
suffered by the Applicant's business or any guarantor in connection with any such information.
7. COLLECTION, USE, AND DISCLOSURE OF PERSONAL AND BUSINESS INFORMATION
(a) The Applicant acknowledges that, as the operation of the Corporation is financially supported by the Government of Canada, representatives of Industry Canada are permitted access to the files of the Corporation for monitoring and evaluation purposes and that the Applicant may be contacted by representatives of Industry Canada and that, such information as is acquired by the Ministry will be treated as confidential.
(b) The Applicant acknowledges receipt of the Corporation's Privacy Statement and hereby consents to his or
her personal and business information being collected, used, retained, and disclosed by the Corporation for
the limited purposes as set out above. The Applicant further understands that under Federal privacy law, he
or she has access to the information held by the Corporation and knows to refer to the Corporation's Privacy
Policy or contact the Chief Privacy Officer if a question or concern arises about the handling of the
Applicant's personal information.
(c) The Applicant further understands and consents to the Corporation publicizing the Applicant's business venture
if the Applicant is successful in obtaining financing from the Corporation, which may or may not include personal
information such as the name of the Applicant.
DATED AT , this day of
   
Name of Witness (If Not Corporation)

Draw your signature below

Applicant Name

Draw your signature below