EQUIPMENT and
TECHNOLOGY LOAN
APPLICATION
EQUIPMENT and
TECHNOLOGY LOAN
APPLICATION FORM
BEFORE COMPLETING THE APPLICATION PLEASE READ THE FOLLOWING:

It is essential that all questions be answered completely and accurately.

All lending decisions will be based upon answers provided in this application.

Financing is in the form of a term loan, not to exceed $7,500 per business.

The financing is to be used solely for the purchase of equipment or technology including a computer or
computers, computer peripherals, projection system, software, Internet access and technology training.

Venture Niagara staff will be available to provide assistance or answer any questions. (Any discussions,
negotiations or communications with our staff, in any form, does not constitute financial commitment by the
Corporation).

Pending approval, all legal costs associated with the loan application process and the release of funds will be
borne by the loan applicant.

Financing terms are as follows:



Minimum loan amount: $2,000
Maximum loan amount: $7,500
The loan will be for a maximum term of 36 months at the interest rate of prime (as declared by the
Bank of Canada) plus 4%.
Example: the monthly payments on a $5,000 loan at prime plus 4% for a total of 10% per annum
would be: 1) $160.86 per month over 36 months, 2) $230.26 per month over 24 months, or 3)
$439.11 over 12 months.

Security for the loan will consist of a personal guarantee and a chattel mortgage on the equipment
being purchased.
Questions?
Contact:
Mr. Frank Rupcic, General Manager
Venture Niagara
905.680.8085
[email protected]
Ms. Kathy DiFiore, Financial Analyst
Venture Niagara
905.680.8085
[email protected]
Venture Niagara Community Futures Development Corporation
20 Pine St. N., Studio A Thorold ON L2V 0A1 T.905.680.8085 Toll Free 1.866.584.6782
[email protected] www.ventureniagara.com
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F.905.680.7253
EQUIPMENT and
TECHNOLOGY LOAN
APPLICATION FORM
Client Consent to Disclose Information to Third Party
I, _____________________________________, give Venture Niagara Community Futures Development Corporation
(“the Applicant”)
(the “Corporation”) permission to disclose my personal information to the following third party service providers:

[Name of Financial Institution ]

[Credit Bureau of Canada]

[Name of Insurance consultant/provider] ___________________________________________________
_________________________________________________________
The use of my personal information by the above providers is limited to the administration of the services as prescribed by
the Corporation and cannot be used for any other purposes.
The information provided to these companies includes the following:

Name, address, phone number, date of birth, gender;

Social Insurance Number (optional);

Job title, Employer;
All personal information changes are to be reported to the Corporation and, in turn, these changes will be reported to the
above-listed service providers.
___________________________
____________________________________
Date
Signature
Venture Niagara Community Futures Development Corporation
20 Pine St. N., Studio A Thorold ON L2V 0A1 T.905.680.8085 Toll Free 1.866.584.6782
[email protected] www.ventureniagara.com
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F.905.680.7253
EQUIPMENT and
TECHNOLOGY LOAN
APPLICATION FORM
Name of Applicant: ________________________________________________________________________________
(First Name)
Address:
(Initial)
(Last Name)
_______________________________________________________________________________
(Street)
(City)
(Province)
(Postal Code)
____________________________
S.I.N. #:
_____________________________
Date of Birth:
Home Phone:
_____________________________
Business Phone: ___________________________
E-mail address: ___________________________________________________________________________________
Year Business
Business Name: ________________________________________________________ Established: _______________
Business Address: _________________________________________________________________________________
(Street)
(City)
Loan Amount requested: $ __________________
(Province)
(Postal Code)
Date money is required: __________________________
YYYY/MM/DD
Please provide two references (personal or business):
1. Name: _________________________________________
Telephone No: _____________________
Address: ________________________________________________________________________________
(Street)
(City)
(Province)
(Postal Code)
2. Name: _________________________________________
Telephone No: _____________________
Address: _________________________________________________________________________________
(Street)
(City)
(Province)
(Postal Code)
Describe how the loan will be used.
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
___________________________________________________________________________________________
Describe your business. What do you do? How will the loan help your business?
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
___________________________________________________________________________________________
Venture Niagara Community Futures Development Corporation
20 Pine St. N., Studio A Thorold ON L2V 0A1 T.905.680.8085 Toll Free 1.866.584.6782
[email protected] www.ventureniagara.com
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F.905.680.7253
EQUIPMENT and
TECHNOLOGY LOAN
APPLICATION FORM
Form of Business Ownership: Proprietorship (
Partners/Officers:
Name
_________________________
_________________________
_________________________
_________________________
) Partnership (
) Corporation (
) Other (
Position/Office
%
Shareholdings
Years
with firm
_____________
_____________
_____________
_____________
____________
____________
____________
____________
_______
_______
_______
_______
)
NB all partners/officers must sign the application
Do you presently have any other loans? ( ) Yes (
If yes,
Amount of Loan
Lending Institution and Address
Outstanding
) No
List all the items you plan to purchase and their cost.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Will you use the purchases as collateral? ( ) Yes
( ) No
If yes, please indicate which purchases _________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Please provide a copy of your most recent financial statement and a copy of the Business
Registration or Articles of Incorporation with this application.
Venture Niagara Community Futures Development Corporation
20 Pine St. N., Studio A Thorold ON L2V 0A1 T.905.680.8085 Toll Free 1.866.584.6782
[email protected] www.ventureniagara.com
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F.905.680.7253
EQUIPMENT and
TECHNOLOGY LOAN
APPLICATION FORM
BORROWER’S WARRANT
I, ______________________________________________ am applying for this loan in good faith, and
(Name of Borrower)
have answered the questions truthfully and to the best of my ability.
Date: _______________________ Signature of Borrower: _________________________________
PROMISSORY NOTE
Amount: $__________________
Date: ______________________
FOR VALUE RECEIVED the undersigned, promises to pay to Venture Niagara Community Futures
Corporation (the “Corporation”) the sum of $ _______________ with interest thereon at the rate of
______ percent per annum, calculated half-yearly and not in advance, with equal monthly installments
on account of principal and interest in the amount of $ ______________ each payment from and
including the ____ day of ____________, 2_____ to the ____ day of ___________, 2_____ the said
monthly sum of $ _________ to be applied firstly in payment of interest and secondly in reduction of
principal; the balance of the principal, if any, to be paid on the last-mentioned date. In the event that
any payment is not made when due, the balance of the loan and accrued interest will become due
immediately at the Corporation’s option and without notice to the undersigned.
The undersigned will pay interest at the above rate on any amount (including interest) not paid when
due and on any judgment. The undersigned, when not in default, shall have the privilege of paying
any additional amount on account of principal at any time without notice or bonus.
(Name of Borrower – please print)
(Signature of Borrower)
__________________________________________________________________________________
(Address)
(City)
(Province)
(Postal Code)
(Telephone No.)
(Name of Borrower – please print)
(Signature of Borrower)
__________________________________________________________________________________
(Address)
(City)
(Province)
(Postal Code)
(Telephone No.)
Date: _______________________
Venture Niagara Community Futures Development Corporation
20 Pine St. N., Studio A Thorold ON L2V 0A1 T.905.680.8085 Toll Free 1.866.584.6782
[email protected] www.ventureniagara.com
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F.905.680.7253
EQUIPMENT and
TECHNOLOGY LOAN
APPLICATION FORM
CHATTEL MORTGAGE
IN RETURN FOR VENTURE NIAGARA COMMUNITY FUTURES DEVELOPMENT CORPORATION (the
“Corporation”) LENDING ME MONEY under the Promissory Note secured by this Chattel Mortgage, I give,
mortgage and grant a security interest to the Corporation one of the following four considerations as of the date of
the Promissory Note:
(1)
(
) Equipment to be purchased with the Corporation’s loan.
(2)
(
) Other business equipment owned by the applicant.
(3)
(
) Vehicle(s) New (
) Used (
) VIN #: _______________________________ Make: ____________
Year: ________ Model: _______________ License No: _________________
(4)
(
) Other (describe specifically): ________________________________________________________
This CHATTEL MORTGAGE agreement will include the following conditions:
(i)
Insurance proceeds on the Property which it protects against any loss in the event of fire, theft, collision,
and any other risks.
(ii)
Any replacement, attachments, accessories, repair parts or other equipment placed on the Property are
considered part of the Property.
(iii)
I promise to keep the Property adequately insured against loss or damage from fire or theft.
(iv)
I promise that I will keep possession of the Property and that I will not sell or lease or transfer any interest
in the Property without the Corporation's permission.
(v)
I promise to pay an administration fee of $50.00 for every cheque I give the Corporation for payment that
is returned N.S.F.
(vi)
If any of the following events take place:
(a)
I fail to pay an installment of the Promissory Note on time; or
(b)
I break any of my promises under this Chattel Mortgage; or
(c)
I should die,
then the total balance of the Promissory Note shall become immediately due.
(vii)
The Corporation may enforce its rights to have me pay the total balance due by:
(a)
Suing me for what I owe the Corporation; or
(b)
Taking possession of the Property, or both. If the Corporation takes possession, I may regain
possession by paying the Corporation the total amount I owe along with the Corporation's
reasonable legal and other expenses of taking and maintaining my Property as permitted by law.
(viii)
When I pay what I owe the Corporation under the Promissory Note and Chattel Mortgage in full, the
Corporation's interest in the Property just described will come to an end.
________________________________
Date
__________________________________________
Borrower’s Signature
________________________________
Date
__________________________________________
Witness’ Signature
________________________________
Date
__________________________________________
Borrower’s Signature
________________________________
__________________________________________
Venture Niagara Community Futures Development Corporation
46 King Street, Suite 201, Welland, ON L3B 3H9 T.905.735.8085 F.905.735.7252
[email protected] www.ventureniagara.com
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EQUIPMENT and
TECHNOLOGY LOAN
APPLICATION FORM
Date
Witness’ Signature
Venture Niagara Community Futures Development Corporation
46 King Street, Suite 201, Welland, ON L3B 3H9 T.905.735.8085 F.905.735.7252
[email protected] www.ventureniagara.com
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