Credit Application

To make your credit application request, please fill the form below. A member of our team will contact you as soon as possible. You may also download the following document, print it, fill it and fax it at (819) 268-2643.

Informations personnelles

* Name
* Address
* City	* Postal Code
* Province	* Country
* Telephone	Fax
Since	* Email

Financial Institution

* Financial Institution
* Address
* Telephone	* Fax
* Account Number
* Comments

Consents

According to the laws aimed at the protection of information, the following consents are given, either :

I consent to that Otelia mandate the Caisse Desjardins de Saint-Paulin to collect from anyone and to hold all necessary information about me in the framework of This folder object. This consent also applies to the update of information in order to fund rescan commitments only I have towards entrepreneurship, particularly in the context of renewals, amendments or changes in the dealings that I have with the company.
I consent that anyone communicates such information same if checkout this information appear in a folder closed or inactive.
I consent to disclosure by the Fund for information about me to the business at any financial institution agent information, or to any other person with whom the company or I have this object business relations of folder.

I read and agree the terms above