1.604.517.0411 Toll Free - 1.888.617.1797 info@canalava.com

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Can Lava Mining Corp

Unit 203-1312 Ketch Court Coquitlam, BC V3K 6W1
Telephone: (888) 617-1797 or (604) 521-8500 Facsimile: (604) 517-0411 Email: admin@canlava.com

CREDIT APPLICATION

TO WARRANT CONSIDERATION, FORM MUST BE COMPLETED, INCLUDING POSTAL CODES



Principles of Firm:




Bank Reference:


Business Credit References:
Terms of Agreement: All invoices are due and payable within 30 days. A service change of 2%

per month will be assessed on all accounts over 30 days old. Accounts over 60 days old will be placed on a C.O.D. basis.


I am the applicant named herein, or an authorized representative of the corporation named herein, and I do agree to the CREDIT TERMS / AGREEMENT as stated above.