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Attenuator Truck Financing

CREDIT APPLICATION

COMPLETE LEGAL NAME:

 

 

  SOLE PROPRIETOR
  PARTNERSHIP
  CORPORATION
  LLC

TYPE OF BUSINESS:

FEDERAL ID NUMBER:

YEARS IN BUSINESS:

MAILING/BUSINESS ADDRESS:

COUNTY:

PHONE NUMBER:

FAX NUMBER:

CELL NUMBER:

LOCATION OF WHERE EQUIPMENT IS KEPT (IF DIFFERENT THEN ABOVE):

INSURANCE AGENT:

AGENT'S PHONE  NUMBER:

ANNUAL SALES:

BUSINESS NET INCOME:

BUSINESS NET WORTH:

PRINCIPAL / OFFICER / PARTNER:

SOCIAL SECURITY #

TITLE &
%OWNED:

HOME ADDRESS:

PERSONAL
NET WORTH:

1.

2.

BANK / MONEY MARKET ACCOUNTS:

ACCOUNT #

TELEPHONE:

OFFICER TO CONTACT:

BUSINESS

BUSINESS

RESIDENTIAL/COMMERCIAL MORTGAGE

 

 

 

 

TRADE / HAULING REFERENCES

ACCOUNT # / TELEPHONE /  CONTACT

 

 

EQUIPMENT LEASE REFERENCE

 

 

 

EQUIPMENT:

 

SUPPLIER:

ADDRESS:

CONTACT:

TELEPHONE:

TYPE OF EQUIPMENT:

NEW/USED:

COST OF EQUIPMENT:

 

 

The undersigned individual, recognizing that his or her individual credit history may be a factor in the evaluation of the credit of the applicant, hereby consents to and authorizes the above named business credit provider and any assignee, lender or funding service that may be utilized to obtain and use a consumer credit report on the undersigned, now and from time to time, as may be needed in the credit evaluation and review process, and, if necessary, any collection actions to be taken on the account.  The undersigned waives any right or claim they would otherwise have under Fair Credit Report Act in the absence of this continuing consent.

I hereby authorize our banks, trades, and personal credit bureaus to release credit information to First Financial LLC and/or its assignees.

TYPE / SIGN NAME:

Email:

102 Oscar Way
Chester Springs, PA 19425

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