Financing Application - Norcal Truck Sales

PURCHASER INFORMATION

Legal Company Name*

Business Phone*

Address*

Street Address City State ZIP Code

Fax

Cell Phone

Email Address*

Federal Tax ID Number*

Years in Business*

No. of Trucks in Fleet*

State of Incorporation*

Choose*

PROPRIETORSHIP
CORPORATION
PARTNERSHIP
LIMITED LIABILITY CO

Principal #1- Name*

Title

Address*

Street Address City State ZIP Code

Home Phone

Cell Phone*

Social Security Number*

Birthdate

Years of Industry Experience*

Principal #2- Name*

Title

Address*

Street Address City State ZIP Code

Home Phone

Cell Phone*

Social Security Number*

Birthdate

Years of Industry Experience*

TRUCK USAGE

Years as Owner/Operator*

Your License Number*

Expiry Date*

State*

Purchaser to Drive?*

Yes
No

*If No, Please Provide Driver Information Below

Driver Info

Driver's Full Name

Experience Years

Social Security Number

Driving License Number

Expiry Date

State

Driver's Address

Street Address City State ZIP Code

Company Name for Truck Work

Off-Highway Use

Yes
No

Average Miles Per Month

Company Address

Street Address City State ZIP Code

If Trucking - Between What Points

Broker Contact

CONTRACT HELD

With Whom?

Contact Name

Contact's Telephone

Years Effective

INSURANCE

Insurance Company

Agent

Policy Number

Telephone

BANK/FINANCIAL ACCOUNTS

Name of Bank or Financial Institutions

Account Type

Savings
Checking

Account Number

Telephone

FINANCE REFERENCES

Name

Address

Account #

Telephone

Name

Address

Account #

Telephone

Name

Address

Account #

Telephone

The Undersigned, who is either a principal of the credit applicant, or a guarantor of its obligations-recognizing that his or her individual credit history may be a factor in the evolution of the credit history of the applicant-authorizes and consents to Nor-Cal Truck Sales & Mfg., Its nominees or its assigns, to review his/her personal credit from a National Credit Bureau. This authorization extends to obtaining ratings from listed banks and trade references. Such authorization shall extend to obtaining a credit profile in consideration of this application and subsequently for the purpose of an update, renewal, or the extension of additional credit is requested. A fax or photocopy of this authorization is to be accepted as an original.

Authorized Signature*

Date*

*MM/DD/YYYY

Phone

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

Nor Cal Truck Sales & Mfg. Application for Financing

PURCHASER INFORMATION

TRUCK USAGE

Driver Info

CONTRACT HELD

INSURANCE

BANK/FINANCIAL ACCOUNTS

FINANCE REFERENCES

Nor Cal Truck Sales & Mfg.
Application for Financing