EmailMeForm
TRUCK PURCHASE FINANCING
Attach the following as a file upload:
- Dealer Invoice/Quote
- Spect Sheet (price, specs, mileage, VIN)
Toal loan amount requested:
*
Business Information:
*
Business Name
Phone #
Email Address
Business Address
State, City, Zip
EIN#
Customer Information:
*
Applicant's Name
Home Address
Rent or Own
Years at Address
% Ownership in Company
Has Applicant ever filed Bankruptcy?
*
Yes
No
If Yes, please explain
Is any applicant a defendant in any legal action?
*
Yes
No
If Yes, please explain
Has any applicant ever had an item repossessed?
*
Yes
No
If Yes, please explain
This Truck is a (check one)
*
1st Truck Purchase
Replacement or Upgrade
Additional Truck
Other
Total # of Trucks Owned
*
Experience:
*
# of Years with CDL
# Years as Owner/Operator
Truck will work for (List Company)
Company Address
Haul Route (Check One)
*
Local
Regional
Long
Other
Hauling (Check all that apply)
*
Dry Goods
Reefer
Flat Bed
Hazardous
Other
*
Do you have your own authority?
Expected Weekly Gross Revenue
Expected Miles/Week
Expected $/Mile
Will Truck be operated in California at least 51% of the time?
CDL# , State, Expiration Date
Will Purchaser be Driving this Truck?
Employment History:
*
Company Name / Position / Length of Employment
Company Name / Position / Length of Employment
Company Name / Position / Length of Employment
Additional Comments, if any:
File Attachment Upload
Submissions that state "See Attached" will be considered incomplete and applicant will be required to re-submit the application.
Dealer Invoice / Quote
Spec Sheet (price, specs, mileage, VIN)
Other
Signature
Name:
*
Phone:
*
Email:
*
Confirm
Person completing the form is:
*
Broker
Principal Borrower(s)
Other
Referral Information (if applicable)
Name of person who referred you:
Email of person who referred you:
Account Executive (if applicable)
If you have been assigned an Account Executive (other than the person who referred you) please enter their email here.
Email of Account Executive:
