Agricultural Application

Customer Information


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NOTE: Applications that result in over $40,000.00 total credit being granted may require more detailed information than we would expect you to complete online. Please contact us at 888-599-1966 and we will have a local representative contact you within 2 business hours or less.
*Were you referred to this site to apply?
Yes     No If Yes, By Whom?

*Full Legal Name
Operating Name
*Mailing Address
*Town
*Province
*Postal Code
*Phone
Fax
Email
*Birthdate (MM/DD/YYYY)
Social Insurance Number

*Type of Farm Operation
Grain     Dairy      Cattle      Poultry     Hog     Other

*Land Coordinates
*Years Farming
Amount of Land Owned
Amount of Land Rented
Amount of Land Cultivated
Gross Yearly Revenue
Secondary Income
Number of Livestock
 
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Required Fields


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