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Owner / Shareholder Details (1)

I/We certify the information I/We have given you about myself and the business is accurate and complete. I/We confirm that the equipment is for business use. The undersigned consents to Jocova Financial Services Corporation its successors and assigns ('Jocova') the collection, use, and disclosure to its affiliates, credit bureaus, reporting agencies, financial institutions, and businesses with whom each of the undersigned has had financial relationships and other references proved in support of this application (and disclosure by these parties to Jocova), of the provided herein and credit and financial information obtained from the above sources for the purposes of obtaining and using a credit information report and verifying current and ongoing creditworthiness of each of the undersigned and other information provided in connection with this application. Jocova may disclose credit and financial information connected with this application to future creditors and lenders that request credit references. SIN's or Social Security Number's (if provided) and other personal identifiers will be used solely for matching of credit bureau/reporting agency information and/or verifying the identity of the undersigned. The undersigned consents to the collection, use, and disclosure of personal information by Jocova and the persons referred to in the related lease, finance, or rental agreement for the above purposes and the purposes described in the related lease, finance, or rental agreement. I/We consent to Jocova Financial to communicate with us electronically related to this transaction as well as other products and services that we may benefit from.

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