Credit Application
Our representative will be in touch with you as soon as we receive your completed application.
If you prefer to send your application by fax you can
print this form.
1)
Applicant (complete legal name of entity)
Business Name
Fax Number
Type of Business
Email Address
Structure
Corporation
LLC
Partnership
Sole Proprietor
Individual
Street Address
Contact Name
City
State
Zip
Phone Number
Year Established
Cell Number
Tax ID or SSN #
2)
Personal Data (all corporate owners, partners, or individuals)
First Name
State
Zip
Last Name
SSN #
Street Address
% Ownership
City
3)
Bank Reference (two-year history)
Name
City and State
Phone Number
Contact Name
Account Number
4)
Equipment
Year
Make
Cost
Down Payment
Term
24
36
48
60
Other
5)
Vendor (supplier of equipment for sale)
Vendor Name
Address
Vendor Contact
City
Phone Number
State and Zip
Fax Number
Authorization
Initial Here
I / We hereby authorize any credit bureau or any other investigative agency to investigate the references herein listed or statements or other data obtained from me / us or from any other person pertaining to my / our credit and financial responsibility.
I / We represent, warrant and affirm that all of the statements made by me / us in this application are true and correct.
Fair Credit Reporting Act disclosure: This application for credit can be submitted to various financial institutions.
Our representative will be in touch with you as soon as we receive your completed application.
If you prefer to send your application by fax you can
print this form.
Information entered in this form will be sent to
TruckLend.com over a secure, encrypted connection.
Tel: 631-439-1700 | Fax: 631-385-6042 | Email: info@trucklend.com
