BUSINESS CREDIT APPLICATION

BUSINESS CREDIT APPLICATION

To McCandless Truck Center, LLC and any of the financing sources they work with, for the purposes of obtaining credit and subsequently for purposes of extending, reviewing, updating and collecting credit, the following complete statement is made: it is agreed that I/We will notify you promptly should there be any material change in my/our financial condition.
Legal Business Name:*
MC/DOT#:*
Federal Tax ID:*
Business Type:*
Select One
Business Start Date:*

MonthDayYear
Date
Business Address:*

Street Address

County

CityState

Zip Code
County
Phone Number:*
Please enter a valid phone number.
Fax Number:
Please enter a valid phone number.
Email:*
example@example.com
Website:*

Principal 1 Name:*

First NameLast Name
Social Security Number:*
% of Ownership:*
Phone Number*
Please enter a valid phone number.
Home Address:*

Street Address

Street Address Line 2

CityState

Zip Code
County
Birthdate:*

MonthDayYear
Date
Principal 2 Name:

First NameLast Name
Social Security Number:
% of Ownership:
Phone Number
Please enter a valid phone number.
Home Address:

Street Address

Street Address Line 2

CityState

Zip Code
County
Birthdate:

MonthDayYear
Date

Bank Name:*
Loan Or Line of Credit?:*
Choose 1
Phone Number*
Please enter a valid phone number.
FAX #:*
Please enter a valid phone number.
Contact:*
Haul Reference & Equipment Lenders (minimum of 1 each):

Name* Account #: Account #* Phone Number* Contact:Full Name*
Name* Account #: Account #* Phone Number* Contact:Full Name*
Name* Account #: Account #* Phone Number* Contact:Full Name*
Currently Owned:

# of Trucks/Tractors:Number of Trucks/Tractors* # of Trailers: Number of Trailers* # of Other:Other*
Ever Filed Bankruptcy?*

YesNo
If Yes, Chapter:
Date of Bankruptcy:

MonthDayYear
Date
Previous Fiscal Year Annual Revenue over $5 Million?*

YesNo
Ever Had Goods/Vehicles Repossessed*

YesNo
If Yes, Please Explain:
Date Occurred:

MonthDayYear
Date
Guarantor:*

First NameLast Name
Birthdate*

MonthDayYear
Date
Social Security Number:*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
County

I / we acknowledge receipt of notice in compliance with the Federal Equal Credit Opportunity Act if applicable. The foregoing application has been carefully read and is in all respects complete, accurate and truthful. I / we authorize and consent to McCandless Truck Center, LLC and any financing sources it works with to obtain the appropriate information, including but not limited to credit bureau reporting agencies references, past credit history and applicant's bank references to establish credit worthiness for financing purposes. Applicant authorizes the financing source to execute and file any UCC financing statements in its name, it determines necessary, upon approval of the application. I / we further represent that said equipment shall be used for commercial purposes and shall not be used for unlawful purpose.
Signature*

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Date*

MonthDayYear
Date
I / we acknowledge receipt of notice in compliance with the Federal Equal Credit Opportunity Act if applicable. The foregoing application has been carefully read and is in all respects complete, accurate and truthful. I / we authorize and consent to McCandless Truck Center, LLC and any financing sources it works with to obtain the appropriate information, including but not limited to credit bureau reporting agencies references, past credit history and applicant's bank references to establish credit worthiness for financing purposes.
Signature of Guarantor*

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Date*

MonthDayYear
Date
Should be Empty:

BUSINESS CREDIT APPLICATION

Haul Reference & Equipment Lenders (minimum of 1 each):

Currently Owned: