REQUIRED LOAN QUESTIONNAIRE

1
Please confirm your email address by typing below:* This field is required.Email confirmation
example@example.com
2
Please list your full legal name* This field is required.
3
How much money do you have to put down for a down payment? This can be in the form of cash, trade or collateral. Please enter a dollar figure.* This field is required.
4
Do you have a CDL?* This field is required.
Yes
No
5
How many years have you had your CDL? If you do not have a CDL, answer N/A.* This field is required.
6
Who will be driving the truck?* This field is required.
Self
Relative
Friend
Independent Contracted Driver
Employee
7
Are you a first time owner operator?* This field is required.
Yes
No
8
For how many years have you been an owner operator? If you are a start up, answer zero.* This field is required.
9
Do you have an established business with an EIN #?* This field is required.
Yes
No
10
How many years have you been in business? If you are a start up, answer zero.* This field is required.
11
What is your federal tax ID number? If you do not have one, answer zero.* This field is required.
12
Why are you purchasing this truck or piece of equipment?* This field is required.
First truck
Replacement unit
Increasing fleet
13
How many trucks or trailers do you currently own? Please list detail description of all equipment owned. If you do not own any equipment, please answer none.* This field is required.
14
What will you be hauling?* This field is required.
15
Where will you be hauling?* This field is required.
Locally, intra-state only
Regionally
Nationwide
16
Do you have your own DOT number?* This field is required.
Yes
No
17
What is the name of the company for whom you will be hauling?* This field is required.
18
What is the name of the contact person for the company for which you will be working?* This field is required.
19
What is the phone number for your haul source?* This field is required.
20
In which state will you be registering your new truck?* This field is required.
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
21
What are your motor carrier and your DOT numbers? If you do not have one, answer zero.* This field is required.
22
Do you own a home?* This field is required.
Yes
No
23
Have you ever had a car or truck repossessed or voluntarily turned into the bank for any reason?* This field is required.
No
Yes, within the last 12 months
Yes, 1-3 years ago
Yes, 4-10 years ago
Yes, more than 10 years ago
Other
24
Have you ever filed bankruptcy?* This field is required.
No
Yes, currently in N open BK
Yes, discharged within the past 12 months
Yes, discharged 1-3 years ago
Yes, discharged 4-10 years ago
Yes, discharged more than 10 years ago
Yes, but recently dismissed
25
If your current credit situation requires it, are you able to put down 40-50% for a down payment in the form of cash, a trade-in or collateral?* This field is required.
Yes
No
26
Are you a United States citizen or permanent resident?* This field is required.
Yes
No
27
Do you have a co-signer if necessary?* This field is required.
Yes
No
Should be Empty: