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Excel - Premier Truck Sales _ Rental - Used Trucks for Sale .xls

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					Credit Application
COMPANY NAME                                              COMPANY PHONE NUMBER                         FAX NUMBER



STREET ADDRESS                                            CITY                                         STATE           ZIP CODE


                                                                                                       BORROWER IS: INDIVIDUAL(I)
CONTACT NAME                                 CONTACT PHONE NUMBER      FEDERAL TAX ID/SOC SECURITY #
                                                                                                       PROPRIETORSHIP(O) PARTNERSHIP(P)
                                                                                                       C-CORP(C) S-CORP(S)

YEAR STARTED                E-MAIL ADDRESS                             # OF TRUCKS IN FLEET            # OF TRAILERS   REPLACEMENT OR EXPANSION



1. OWNER NAME                                             % OWNED      TITLE                                           SOCIAL SECURITY #



ADDRESS                                                   CITY                                         STATE           ZIP CODE



2. OWNER NAME                                             % OWNED      TITLE                                           SOCIAL SECURITY #



ADDRESS                                                   CITY                                         STATE           ZIP CODE




CREDIT REFERENCES-WE NEED ALL ACCOUNT & PHONE NUMBERS PLUS CONTACTS FOR FAST ANSWERS!!
PRIMARY BANK NAME AND ADDRESS                ACCOUNT TYPE ACCOUNT NUMBER(S)          CONTACT                           PHONE NUMBER




FINANCE REFERENCE                                         ACCOUNT NUMBER             CONTACT                           PHONE NUMBER



FINANCE REFERENCE                                         ACCOUNT NUMBER             CONTACT                           PHONE NUMBER



LANDFILL/DISPOSAL SITE                                    ACCOUNT NUMBER             CONTACT                           PHONE NUMBER



TRADE REFERENCE (TIRES OR REPAIRS)                        ACCOUNT NUMBER             CONTACT                           PHONE NUMBER



TRADE REFERENCE (TIRES OR REPAIRS)                        ACCOUNT NUMBER             CONTACT                           PHONE NUMBER




WORK REFERENCES
COMPANY NAME                MONTHLY/YEARLY REVENUE        DURATION OF CONTRACT       CONTACT                           PHONE NUMBER



COMPANY NAME                MONTHLY/YEARLY REVENUE        DURATION OF CONTRACT       CONTACT                           PHONE NUMBER




                                                                                       Premier Truck Sales & Rental, Inc. Credit Application Page 1
EQUIPMENT PURCHASE INFORMATION
YEAR          MAKE                                                       MODEL                                        BODY TYPE




SALE PRICE                       $_____________________________          LOAN OR LEASE                 _______________________________

TRADE-IN AMOUNT                  $_____________________________          TERM                          _______________________________

AMOUNT OWED ON TRADE             $_____________________________
                                                                         BALLOON OR PURCHASE
CASH DOWN PAYMENT                $_____________________________          OPTION AMOUNT                 _______________________________

AMOUNT TO FINANCE                $_____________________________          SKIPS                         _______________________________


By signing below, each of us certifies that:
(1) The information provided in the accompanying credit application (whether your form or someone else's) and any financial statements, tax
returns, or similar items are true and correct and (2) I have not omitted or failed to include material information relevant to the credit
application. Each of the undersigned authorizes Premier Truck Sales, Inc. ("PTS") and its authorized agents to conduct inquiries regarding
the undersigned's business operations and individual and business credit histories as it may deem necessary including, without limitation,
requesting credit bureau reports, contacting banks, secured lenders, lessors and trade creditors for references and for information on Bank
accounts, Loans, or Leases. I/we authorize all parties contacted by PTS to verify the information contained in this application. I/we authorize
all parties contacted to release credit and financial information requested as part of said verification. I/we agree that anyone receiving a fax
or photocopy of this document may act in reliance thereon to the same degree as if they possessed an original.
All individuals applying for credit as a guarantor of any loan or lease must sign.

The Equal Credit Opportunity Act (ECOA) prohibits a creditor from discriminating against a credit applicant on the basis of race, color,
religion, national origin, sex, marital status, or age (provided the applicant has the capacity to enter into a binding contract), because all or
part on the applicant's income comes from any public assistanace program, or becuase the applicant has, in good faith, exercised any right
under the Consumer Credit Protection Act. The Federal Trade Commission administers compliance with ECOA. You may contact the
Federal Trade Commission at 600 Pennsylvania Avenue, NW, Washington, DC 20580. If you application is denied, you are entitled to
request a written statement indicating the reason(s) for our decision.

PRIVACY, THE PATRIOT ACT, AND OPENING AN ACCOUNT
Federal law requires Premier Truck Sales, Inc.'s authorized agents to obtain, verify and record information that identifies each person or
entity that opens an account or applies for credit. This information helps the government fight the funding of terrorism and money laundering
activities. When you open an account or apply fo ra loan or lease, we will ask you for your name, address, date of birth, and Social Security
or EIN number. For a business, we will ask for your company's name, address, and Tax Identification number. In some instances we may
also ask to see your driver's license or other identifying documents.


SIGNATURE_________________________________________________________       TITLE__________________________________      DATE_____________________




SIGNATURE_________________________________________________________       TITLE__________________________________      DATE_____________________




               Finance options available at Premier Truck Sales for qualified buyers…
                          ..   Bank Financing
                          ..   Up to a 72 month Term
                          ..   Up to 120 days until First Payment
                          ..   Token Payments for Slow Months
                          ..   Competitive Rates
                          ..   Quick Approval
                          ..   Straighforward Paperwork
               Ask your Sales Rep or Premier's Finance Department for Details!

                                                                                         Premier Truck Sales & Rental, Inc. Credit Application Page 2

				
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