APPLICANT DATA
Legal Company Name
Trade Style (DBA)
Year Established
Federal Tax ID Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Person to Contact
Business Telephone #
Format: (000) 000-0000.
Business Fax #
E-Mail Address
example@example.com
Entity Type (check one box)
Corporation
Partnership
Proprietorship
LLC
C Corp.
S Corp.
Other
Current Fleet Size:
Coaches
Mid Size Buses
Shuttles/Vans
School Buses
Limo's
Other
List Affiliated Companies or Subsidiaries
PARTNERS, GUARANTORS AND PRINCIPALS
1. Principal Owner
*
% Ownership
Title
Social Security Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2. Principal Owner
% Ownership
Title
Social Security Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
EQUIPMENT TO BE FINANCED
Quantity
Year, Manufacturer, Model
$ Requested
Terms
Replacement
Lease
Loan
INSURANCE INFORMATION
Insurance Company Name (Liability & Physical Damage)
Agent
Telephone #
Format: (000) 000-0000.
CREDIT REFERENCES
Bank Name
Account Number(s)
Contact
Telephone #
Format: (000) 000-0000.
Bank Name
Account Number(s)
Contact
Telephone #
Format: (000) 000-0000.
Finance Company Name
Account Number(s)
Contact
Telephone #
Format: (000) 000-0000.
Finance Company Name
Account Number(s)
Contact
Telephone #
Format: (000) 000-0000.
Finance Company Name
Account Number(s)
Contact
Telephone #
Format: (000) 000-0000.
COMPANY HISTORY/INFORMATION
COMPANY HISTORY/INFORMATION
REASON FOR ACQUISITION
REASON FOR ACQUISITION
*
I certify that the information stated in this application is true and correct. I understand that you will retain this application whether or not it is approved. You and/or entities to whom you refer this application authorized to check my credit and employment history, obtain insurance information and to answer questions about your credit experience with me. I authorize you and/or entities to whom you refer this application contact my creditors and authorize any creditor contacted to release to you such credit information you may request.
Signature
*
Title
*
Date
*
-
Month
-
Day
Year
Date
Notice: To help the government fight the funding of terrorism and money laundering activities, U.S. Federal law requires financial institutions to obtain, verify and record information that identifies each person (individuals or businesses) who opens an account. What this means for you: When you open an account or add any additional service, we will ask you for your name, address, and taxpayer identification number that will allow us to identify you. We may also ask to see other identifying documents.
Co-Signature
Title
Date
-
Month
-
Day
Year
Date
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