IState Truck Center Credit Application

Primary Applicant




State
Date

No PO Box
Example: MM/DD/YYYY

Company Guarantor/Co-Buyer/Driver Information



No PO Box
Example: MM/DD/YYYY

Driving History

Ex. 5 years 8 months
Ex. 5 years 8 months

Employment History

Work/Haul References within last 2 years

Equipment

Currently Owned Trucks, Tractors, and Trailers - Open and Paid

Purpose

Brief Description of Operations - Include MATERIAL HAULED, if 1st truck, replacement, or expansion of fleet

I/We authorize you to obtain such information as you may require concerning the statements in this application and
agree that the application shall remain your property whether or not the lease or loan is granted. I/We understand
and agree that you may assign or transfer this credit application to other third party lending institutions. I/We
hereby certify that all statements contained in this application, as well as other information provided, are true
and complete, and are made for the purpose of obtaining credit. I/We agree to notify you of any material changes
in the conditions of affairs, and this statement shall be construed by you to be a continuing statement of the
conditions of the Lessee until written notice to the contrary is received by you. Lessee and its principals authorize
the release of credit information to the Lessor.

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