Business Finance Request

Company name

Title
Mr. Ms.

Name (first name, initial(s), last name)

Address

City

Postal code

Province/Territory
Select your province *Not in Canada Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory  

Telephone (with ext.)
     

Email (Optional)

Industry sector

Project description

Outline the project(s) the business requires financing for, and expected sources of financing needed (internal and external sources of funds). Total costs of project must equal all sources of financing.

Project

Cost ($)

Select building/construction purchase of real estate equipment purchase purchase an existing business leasehold improvements inventory increase reduce payables market development refinancing startup costs  

Select building/construction purchase of real estate equipment purchase purchase an existing business leasehold improvements inventory increase reduce payables market development refinancing startup costs  

Select building/construction purchase of real estate equipment purchase purchase an existing business leasehold improvements inventory increase reduce payables market development refinancing startup costs  

Select building/construction purchase of real estate equipment purchase purchase an existing business leasehold improvements inventory increase reduce payables market development refinancing startup costs  

Select building/construction purchase of real estate equipment purchase purchase an existing business leasehold improvements inventory increase reduce payables market development refinancing startup costs  

Other 

Other cost ($)

Source of financing

Amount requested ($)

Financing requested thru CFCL

Select owner/shareholder chartered bank other financial institution private investor working capital/earnings another business insurance proceeds grants balance from a sale  

Select owner/shareholder chartered bank other financial institution private investor working capital/earnings another business insurance proceeds grants balance from a sale  

Select owner/shareholder chartered bank other financial institution private investor working capital/earnings another business insurance proceeds grants balance from a sale  

Select owner/shareholder chartered bank other financial institution private investor working capital/earnings another business insurance proceeds grants balance from a sale  

Other 

Other amount ($)

How will this project benefit your business?

Have you requested financing from any other Lender in the last 12 months?

If yes, which bank/ Financial Institution/ Lender?

Additional information

Start-up year

Annual revenues

Do you need consulting services? (Optional)

Comments