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Applicant's Information

Applicant's Full Legal Name (hereinafter known as applicant):

Applicant's First Name *

Applicant's Middle Name

Applicant's Last Name *

Applicant's Email

Applicant's Date of Birth *

S.I.N. (optional)

I would like to add a co-applicant/spouse to my account.

Co-applicant's Information

Co-applicant's Full Legal Name

Co-applicant's First Name

Co-applicant's Middle Name

Co-applicant's Last Name

Co-applicant's Email

Co-applicant's Date of Birth

Co-applicant's S.I.N. (optional)

Principal Residence

Address 1 *

Address 2

City *

Home Phone *

Work Phone

Cell Phone

Employer Information

Applicant's Employer

Present Employer

Position

Phone

Previous Employer (if less than three years at current job)

Co-applicant's Employer

Present Employer

Position

Phone

Previous Employer (if less than three years at current job)

More Information

Your Current Financial Institution *

Branch *

Yes, I have chosen 'Automatic Delivery' and yes I am aware of the terms and conditions of the 'No Run Out Program'. (OAC)

Yes, I have been offered the Worry Free Service Plan and at this time I do not wish to purchase it. (If available in your area.)

Account statements are issued by e-mail on a monthly basis. Please ensure you have provided an active e-mail address on this application.

Submit Your Application

I HAVE READ AND AGREED TO THE TERMS AND CONDITIONS *

Terms and Conditions

Terms and Conditions The Applicant, including any co-applicant/spouse who has also applied for credit and signed below (together, the “Applicant”) hereby expressly consents to McDougall Energy Inc. together with its affiliates, successors and assigns, (“McDougall Energy”) obtaining a third party credit report on the Applicant, for on-going account monitoring and debt collection purposes. The Applicant represents and warrants to McDougall Energy that all information is complete and correct and agrees to advise McDougall Energy immediately of any change to any such information. The Applicant authorizes McDougall Energy to contact the employer(s) and financial institution indicated by you in this Application for the purposes of completing its credit review. The Applicant hereby agrees that nothing herein shall bind or compel McDougall Energy to advance credit to the Applicant. McDougall Energy shall determine, in its sole discretion based on a review of this Application, whether to grant credit to the Applicant and on what terms. The Applicant shall be responsible for all credit it receives from McDougall Energy whether or not such credit exceeds authorized credit limits or payment terms established by McDougall Energy. The Applicant further agrees to pay interest in the amount of two (2.0%) per cent per month (twenty-four (24%) percent annually, non-compounded) for all accounts past due and shall be responsible for all costs incurred (including but not limited to court filings, legal fees etc.) by McDougall in order to collect payment.

Privacy Notice

By submitting this Application, the Applicant confirms that it consents, or if the Applicant is a business, that the principal(s) and/or partner(s) of the Applicant consents, to McDougall Energy obtaining and using the credit and/or personal information of the Applicant, as may be required from time to time in connection with the credit applied for herein, or any renewal or extension thereof, and to McDougall Energy disclosing such credit and/or personal information to any credit reporting agency, debt collection agency or to any commercial bank or financial institution with whom the Applicant has financial relations in furtherance of the credit applied for herein. If the Applicant has voluntarily disclosed his/her Social Insurance Number (“SIN”) on this Application, the SIN will only be used by McDougall Energy to confirm the identity of the Applicant for the purpose of performing a credit check. McDougall Energy shall not sell the Applicant’s information without the Applicant’s prior written consent.

The Applicant’s information will be held at McDougall Energy’s Credit Department at the following address: 421 Bay Street, Suite 301, Sault Ste. Marie, ON P6A 1X3 and will only be accessible to employees of McDougall Energy.

For further information on McDougall Energy’s Privacy Policy or to withdraw its consent pursuant to this section the Applicant may contact McDougall Energy’s Credit Department at (705)949-6202 or if the Applicant requires a copy of McDougall Energy’s Privacy Policy it may be accessed from the website: www.mcdougallcorp.com.

NOTE: by selecting “SUBMIT”, the Applicant agrees to the terms and conditions of this Credit Application.

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