Prairie Truck Sales
Credit Application |
APPLICATION TYPE |
Partnership
Proprietorship
Nonprofit Org
Corporation
Corporation Tax ID Number, if applicable |
Salesman You Spoke With:
(Important) |
|
PERSONAL INFORMATION |
Purchaser to Drive? |
Yes No
... If No ...
|
Primary Applicant Full Name |
|
License # |
(With State + Expiration Date) |
Date of Birth |
Age |
SSN |
No. Dep |
Spouse Full Name |
|
Date of Birth |
Age |
SSN |
|
Business Phone |
|
Residence Phone |
|
Present Address |
|
City-State-Zip |
|
How Long? |
Years
& Months |
Own/Rent |
Own
Rent
Mortgage/Rent Paid To
|
Former Address |
|
City-State-Zip |
|
CORPORATION INFORMATION |
Corporation Name |
|
Incorporated In What State |
|
Date of Incorporation |
|
Date In Business |
|
Principal |
Age |
Principal Title |
% Owned |
Principal |
Age |
Principal Title |
% Owned |
NEAREST RELATIVES NOT
AT ABOVE ADDRESS |
|
EMPLOYMENT - PAST AND
PRESENT - FIVE YEARS |
|
How Long as an Owner-Operator? |
|
Nature of Business |
(Materials, Between What Points,
Construction, Over-The-Road, Etc.) |
Monthly Income |
|
TRADE-IN DESCRIPTION |
|
PURCHASER'S FINANCIAL
AND CURRENT CREDIT STATEMENT |
Examples: How To Fill Out This Section
|
Have you filed bankruptcy in the last 10 years? |
Yes No |
Any Items Repossessed? |
Yes No |
SIGN AND DATE |
The information given above is true and
complete. Lender may receive from and disclose to other persons,
including credit reporting agencies, information about Applicant's
accounts and credit experience and Applicant authorizes any person
to release to Lender credit experience and account information on
Applicant. This shall be a continuing authorization for all
present and future disclosures of account information and credit
experience on Applicant made by Lender or any person requested to
release such information to Lender. |
|
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