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NorCal Truck Sales in Benicia
200 Industrial way Benicia, CA 94510 707-748-4498
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Financing

Please fill out the following form as completely as possible.

 
Applicant Information
First Name:
Last Name:
E-mail Address:
Company:
Address:
City:
State:
Zip:
How Long At Address:
Own Or Rent:
Mortgage/Rent Paid To:
Prior Address:
Prior City:
Prior State:
Prior Zip:
Business Phone:
Evening Phone:
Cell Phone:
Fax:
Date of Birth:
Age:
Social Security Number:
Number of Dependents:
Spouse Full Name:
Spouse Birth Date:
Spouse Age:
Spouse SSN:
Applicant:
Corporate Tax ID: Only if Corporation
License Number: Include State and Expiration Date
About The Driver
Purchaser to Drive:
Driver's Name:
Driver's Date of Birth:
Driver's License Number:
Corporate Information (If Corporation)
Corporation Name:
State Incorporated:
Date of Incorporation:
Date In Business:
Principal 1 Full Name:
Title:
Age:
Ownership %:
Principal 2 Full Name:
Title:
Age:
Ownership %:
Nearest Relatives Not At Address Above
Name 1:
Address:
City:
State:
Phone:
Relationship:
Name 2:
Address:
City:
State:
Phone:
Relationship:
Name 3:
Address:
City:
State:
Phone:
Relationship:
Name 4:
Address:
City:
State:
Phone:
Relationship:
Employment History Last 5 Years
Company Name 1:
Contact Name:
Contact Phone:
Address:
Your Position:
How Long:
Company Name 2:
Contact Name:
Contact Phone:
Address:
Your Position:
How Long:
Company Name 3:
Contact Name:
Contact Phone:
Address:
Your Position:
How Long:
How Long As Owner/Operator:
Nature of Business:

Materials, Between What Points, Construction, Over-The-Road, Etc

Monthly Income:
Trade In Description
Year:
Make:
Model:
Body Style/Type:
Engine:
Transmission:
Rears:
Serial Number:
Sleeper:
Tractor Package:
Other Info:
Title State:
Months In Loan:
Payment Amount:
Amount Still Owed:
Financial and Credit Statement

Be sure to include all assets including real estate, savings accounts, trucks, trailers, automobiles and loans and all liabilities including credit cards, fuel bills, etc.

Description 1: Savings
Bank: First Bank
Phone: (123)123-1234
Account Number: 12341234
Asset Value: 6400
Payment Amount:
Amount Owed:
Description 2: Checking Account
Bank: First Bank
Phone: (123)123-1234
Account Number: 12341234
Asset Value: 3200
Payment Amount:
Amount Owed:
Description 3: 99 Ford Explorer
Bank: ABC Bank
Phone: (800)123-1234
Account Number: 1234512345
Asset Value: 18000
Payment Amount: 510
Amount Owed: 14000
Description 4:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 5:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 6:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 7:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 8:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 9:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 10:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 11:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 12:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 13:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 14:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Description 15:
Bank:
Phone:
Account Number:
Asset Value:
Payment Amount:
Amount Owed:
Final Questions
Bankruptcy Within 10 Years:
Any Items Repossessed:
Signature

The information given above is true and complete. Lender may receive from and disclose to other persons, including credit reporting agencies, information about Applicant's accounts and credit experience and Applicant authorizes any person to release to Lender credit experience and account information on Applicant. This shall be a continuing authorization for all present and future disclosures of account information and credit experience on Applicant made by Lender or any person requested to release such information to Lender.

Signed: September 26th, 2018
E-mail Address:

Email:David Jenkins / Owner / norcaltruck@sbcglobal.net

Call Toll Free:1-888-781-2386

Locally:1-707-748-4498

Fax: 1-707-748-4276