Avenue International Inc. credit application requests company and shareholder information including company name, address, contact details, business structure, incorporation details, industry, previous business names in the last 5 years, names and ownership percentages of shareholders, convictions, bankruptcies, and lawsuits. The applicant authorizes Avenue International to obtain a credit profile and all information is kept confidential. The completed application should be sent to Avenue International's Toronto office.

1. AVENUE INTERNATIONAL INC.
Credit Application
Pg 1
All information kept strictly confidential
1.) Company Information
Company Name: ______________________________________________________________
Business Address: ____________________________________________________________
City: _______________________________________________________________________
State/Province: ______________________________________________________________
Country: ___________________________________________________________________
Contact Name: __________________ Position:_____________________________________
Phone: ________________________ Fax: ________________________________________
E:mail: ___________________________ Web-site : _________________________________
Business Structure:
⋅ Corporation __
⋅ Limited Partnership __
⋅ Sole Proprietorship __
⋅ Other: ___________________________________________________________
Place of Corporation: _________________________________________________________
Date of Incorporation: _________________________________________________________
Industry- Type of Business: ____________________________________________________
Previous Business names used over the past 5 years if different than above:
_____________________________________________________________________________________________

2. Pg 2
2.) Shareholders
Name: ________________________________________ Title _________________________ % Ownership _______
Name: ________________________________________ Title _________________________ % Ownership _______
Name: ________________________________________ Title _________________________ % Ownership _______
If other major share holders attach information on a separate sheet
Have any of the officers or owners of the company been convicted of a felony? No ___ Yes ___ *
Have any of the officers or owners of the company been involved in a bankruptcy? No __ Yes ___ *
Are there any lawsuits pending against the company No ___ Yes ___ *
* If yes, please attach a written explanation
Professional Services
Bank: _______________________________ Address: _________________________________
Contact: ______________________________ Phone: _________________________________
Insurance Company: _____________________________________ Phone: _________________
Accountant / Auditor: ________________________________ Phone: _____________________
Lawyer: __________________________________________ Phone: ______________________

3. Pg 3
We declare the above information is true, correct and complete. The applicant authorizes Avenue International Inc. to
obtain any information required to establish a credit profile of the applicant for future business transactions. All
information is kept strictly confidential.
___________________________________________ Name: ____________________________________
signature
Title: _____________________________________
___________________________________________ Name: ____________________________________
signature
Title: _____________________________________
Date: _________________________________________
Please send the completed application to:
Avenue International Inc.
85 Collier St 2nd Floor
Toronto Ontario
CANADA
M4W 1M1
davecunningham@sympatico.ca