Financing

Business Information (Please Note: If you are not applying as a business, you may skip the first eight questions and move to "Number Yrs. Driver") Business Name Type of Business Address City State Zip Business Phone Business Tax ID Number Number Yrs. Driver Number Yrs. Owner/Operator Number of trucks owned Number of trailers owned First Credit Reference Name of Creditor Contact Name Phone Number Second Credit Reference Name of Creditor Contact Name Phone Number Company Name Truck is to be leased to Contact Name Phone Company Name Truck is to be leased to Contact Name Phone Relative Information - Nearest relative of yours not living with you: Name Address City State Zip Relationship Phone

Have you ever taken bankruptcy? Yes No Are you a defender in any legal action? Yes No Have you ever had items repossesed? Yes No Buyer to Drive? Yes No