Credit Application | American Fleet Sales

Business / Company Information

Legal Name of Business Entity(Required)

Contact Person

Street Address

City

State

Zip

Phone Number(Required)

Email(Required)

Federal Tax ID #

Nature of Business

MC #

# of Trucks

# of Trailers

Years Time in Business

First Time Buyer?

Yes

Ownership / Guarantor Information

Principal 1

Principal 1 - Principal's Name(Required)

Principal 1 - Title

Principal 1 - % Ownership

Principal 1 - Date of Birth(Required)

Principal 1 - Social Security Number(Required)

Principal 1 - Home Address

Principal 1 - City

Principal 1 - State

Principal 1 - Zip

Principal 1 - Rent / Own

Rent

Own

Principal 1 - Home Phone

Principal 1 - Driver's License #(Required)

Principal 2 (if applicable)

Principal 2 - Principal's Name

Principal 2 - Title

Principal 2 - % Ownership

Principal 2 - Date of Birth

Principal 2 - Social Security Number

Principal 2 - Home Address

Principal 2 - City

Principal 2 - State

Principal 2 - Zip

Principal 2 - Rent / Own

Rent

Own

Principal 2 - Home Phone

Principal 2 - Driver's License #

Haul Information

Current Company Name

Current - Contact Person

Current - Ph #

Current - How Long?

Previous Company Name

Previous - Contact Person

Previous - Ph #

Previous - How Long?

Comparable Credit References (Equipment Financing)

Reference 1 - Company Name

Reference 1 - Account #

Reference 1 - Ph #

Reference 1 - Contact

Reference 2 - Company Name

Reference 2 - Account #

Reference 2 - Ph #

Reference 2 - Contact

Reference 3 - Company Name

Reference 3 - Account #

Reference 3 - Ph #

Reference 3 - Contact

Bank Information

Bank 1 - Bank Name & Branch

Bank 1 - City/State

Bank 1 - Phone #

Bank 1 - Account Type

Bank 1 - Account Number

Bank 2 - Bank Name & Branch

Bank 2 - City/State

Bank 2 - Phone #

Bank 2 - Account Type

Bank 2 - Account Number

Personal References

Personal Reference 1 - Name

Personal Reference 1 - Phone #

Personal Reference 1 - 2nd Phone #

Personal Reference 1 - Street Address

Personal Reference 1 - City

Personal Reference 1 - State

Personal Reference 1 - Zip

Personal Reference 1 - Relationship

Personal Reference 2 - Name

Personal Reference 2 - Phone #

Personal Reference 2 - 2nd Phone #

Personal Reference 2 - Street Address

Personal Reference 2 - City

Personal Reference 2 - State

Personal Reference 2 - Zip

Personal Reference 2 - Relationship

Have you filed for Bankruptcy protection in the past ten years?

Yes

Do you have any outstanding liens or judgments?

Yes

THE UNDERSIGNED HEREBY AUTHORIZES OUR BANKS, TRADES, AND REFERENCES TO RELEASE CREDIT INFORMATION TO AMERICAN FLEET SALES INC OR THEIR ASSIGNS. I/WE WARRANT THE ACCURACY OF THE INFORMATION IN THIS APPLICATION AND ANY OTHER FINANCIAL INFORMATION SUBMITTED BY THE UNDERSIGNED. ALL INFORMATION WILL BE HELD IN THE STRICTEST CONFIDENCE.

I agree and authorize(Required)

I agree and authorize

Signed(Required)

Signed (second principal)

Date

Phone

This field is for validation purposes and should be left unchanged.