DISCLAIMER: I/We certify the information I/We have given you about myself and the business is accurate and complete. The undersigned consents to TransacWell its successors and assigns ('TransactWell') the collection, use, and disclosure to its affiliates, partners, lenders, 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 TransactWell), 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. TransactWell 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 TransactWell and the persons referred to in the related finance, lease, loan or other agreement(s) for the above purposes and the purposes described said agreements. We acknowledge that TransactWell may transfer to, and store Information in, jurisdictions where TransactWell does business. As a result, Information may be accessible to regulatory authorities in accordance with the laws of these jurisdictions. You further consent to receive electronic communications from us with regards to our dealings and/or any potential future promotions of services we may market to you.

Acceptance *