Credit Application Form 1.2

Personal/Business Information

This is a soft pull on your credit, no affect on your score!
Name*

First NameMiddle NameLast NameSuffix
Business Name
if applicable
EIN/Tax ID
if applicable
LLC was created on:

MonthDayYear
if applicable
Date of Birth*

MonthDayYear
Social Security Number *
XXX-XX-XXXX
Mobile Number*
E-mail*
example@example.com
Residence
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have you lived at the above address?*

0-1 Year1-2 Years3-4 Years5+ Years
Home Ownership/Rent.*

OwnRentLiving with parents or relative
Experience
Are you a first time buyer?*

YesNo
Have you ever filed for Bankruptcy or had a repossession?*

YesNo
Do you have any accounts in collections or severely past due?*

YesNo
What type of equipment are you applying for? *
what are you wanting to buy
How much do you have for a down payment?*
If buying truck, CDL experience in years/months*
If Owner Operator experience, how many years/months?*
Employment Information
Present Employer/ Business Name:*
Phone Number (Employer/Business) *
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years/months with the Company*
Gross monthly income*
I hereby authorize, consent and instruct Wheelhouse Lease and Finance LLC to obtain and review my credit report. This report will be obtained from a credit reporting bureau chosen by Wheelhouse. I agree that the credit report will be used for the purpose of reviewing my credit for readiness for lease or purchase of equipment. A copy of this authorization shall be as valid as the original.*

Clear
Digital Signature required
Data Privacy Act and Consent Form. I/We likewise give my/our consent to Dealers, Wheelhouse Lease and Finance LLC, Brokers and Banks to share and disclose the personal or sensitive personal information.*

YES
I hereby agree that the information given is true, accurate and complete as of the date of this application submission.*

YES
I hereby accept the treatment of my personal data by Wheelhouse for market analysis including verifying customer satisfaction, market survey, and polls delivered through automated systems such as email, SMS or newletters.

YES
Should be Empty:

Personal/Business Information

Residence

Experience

Employment Information