|APPLICATION FOR FINANCING
|1. THE APPLICANT:
|Principal place of business at:
|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:
|4. AND MAKES THE FOLLOWING STATEMENTS:
|5. THE APPLICANT UNDERSTANDS AND AGREES:
|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.
|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;
|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;
|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
|The Applicant acknowledges that he or she approached the Corporation to obtain information about business and has, or is preparing a business plan.
|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.
|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
|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.
|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.
|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.
Name of Witness (If Not Corporation)
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