Test Credit App

Credit Application
If Your Business Is Less Than 3 Years Old You Must Apply As An Individual
Applying As
Operating Authority
Contact Information
Applicant Name

First NameLast Name
Applicant Title or Role
Applicant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Applicant Email
example@example.com

Business Information
Legal Business Name
DBA (Doing Business As)
Type of Business
FEIN
Years in Business
Business Phone
Please enter a valid phone number.Format: (000) 000-0000.
Business Email
example@example.com

Address Information
Physical Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Billing address same as physical address?
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Operating Authority Details

Enter the operating authority information under which your company will operate our trailers. This may be your company’s authority or another carrier’s authority.
Legal Name of Authority
As filed with FMCSA
USDOT Number
Motor Carrier Number
Agreement between the parties

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Who is Responsible For Comprehensive Automobile Coverage?
Who will be responsible for the trailer's insurance?

Insurance Information
Insurance Provider
Insurance Agent Name

First NameLast Name
Insurance Agent Email
example@example.com
Insurance Company Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Bank Reference
Bank Name
Last 4 Digits of Account Number
Account Type
Branch Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Upload the account-summary page from each of your three most recent bank statements. You may redact transaction details and other information not needed for credit review.
Bank Statement — Most Recent Month

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Bank Statement — Prior Month

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Bank Statement — 2 Months Prior

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SAVE TIME ON THE NEXT STEP — OPTIONAL
If you are approved and decide to move forward with a rental, a payment method will be required before pickup. You can securely provide it now to save time and avoid completing this step later.

No payment, deposit, fee, or other amount will be charged or withdrawn when you submit this application. Adding a payment method does not start a rental, reserve a trailer, or affect your credit decision.
Would You Like to Submit Your Preferred Payment Method to Store on File
Your payment information will be securely collected and stored by our payment processor. 66Trailers, LLC will not receive or store your complete card number or bank-account number.

No rental payment, security deposit, fee, or other amount will be charged or withdrawn solely because you submit this credit application. Providing a payment method does not create a rental agreement, reserve a trailer, or guarantee approval.

If your application is approved and you choose to rent a trailer, you will receive a separate rental agreement and payment authorization identifying the assigned trailer, rental rate, security deposit, billing start date, 28-day billing schedule, LDW charge if applicable, and other authorized amounts.

Trailer Needs
Trailer Type

Other (Describe Below)
How Many Trailers
Oldest acceptable trailer (Year)
What Program Are You Interested In?
Other Preferences
Estimated Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Personal Authorization

Authorization to obtain consumer credit information
Personal Applicant Name

First NameLast Name
Social Security Number
Business Authorization

Authorization to obtain business credit information
Authorized Business Representative Name

First NameLast Name
Please submit an official form of ID (driver's license, CDL, etc.)

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Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Credit Application

If Your Business Is Less Than 3 Years Old You Must Apply As An Individual

Contact Information

Business Information

Address Information

Operating Authority Details

Insurance Information

Bank Reference

SAVE TIME ON THE NEXT STEP — OPTIONAL

Trailer Needs

Personal Authorization

Business Authorization