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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 Ms. Kathy DiFiore, Financial Analyst Venture Niagara Venture Niagara 905.680.8085 905.680.8085 [email protected] [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 F.905.680.7253 [email protected] www.ventureniagara.com 2 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

Name of Applicant: ______(First Name) (Initial) (Last Name) Address: ______(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) (Province) (Postal Code)

Loan Amount requested: $ ______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. ______

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 F.905.680.7253 [email protected] www.ventureniagara.com 4 EQUIPMENT and TECHNOLOGY LOAN APPLICATION FORM Describe your business. What do you do? How will the loan help your business? ______

Form of Business Ownership: Proprietorship ( ) Partnership ( ) Corporation ( ) Other ( )

Partners/Officers: % Years Name Position/Office Shareholdings with firm

______

NB all partners/officers must sign the application

Do you presently have any other loans? ( ) Yes ( ) No If yes, Amount of Loan Lending Institution and Address Outstanding

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 ______

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 F.905.680.7253 [email protected] www.ventureniagara.com 5 EQUIPMENT and TECHNOLOGY LOAN APPLICATION FORM ______

Please provide a copy of your most recent financial statement and a copy of the Business Registration or Articles of Incorporation with this application.

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.

(Signature of Borrower) (Name of Borrower – please print)

______(Address) (City) (Province) (Postal Code) (Telephone No.)

(Signature of Borrower) (Name of Borrower – please print)

______(Address) (City) (Province) (Postal Code) (Telephone No.)

Date: ______

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.

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 F.905.680.7253 [email protected] www.ventureniagara.com 7 EQUIPMENT and TECHNOLOGY LOAN APPLICATION FORM (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

______Date Witness’ 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 F.905.680.7253 [email protected] www.ventureniagara.com 8