Business Type*

Corporation
Partnership
LLC
DBA
Owner Operator

Business

Exact Legal Name of Business*

Federal Tax ID#*

Business Phone*

Business
Mobile

Address*

Street Address City State ZIP Code

Years In Business*

Date of incorporation*

State of incorporation*

Owner Operator/Business Guarantor

Name*

First Middle Last

Birthdate*

Social Security #*

Phone*

Title*

% Ownership*

Email*

Address*

Street Address City State ZIP Code

Monthly Payment*

Own
Rent

Resided at address 5 or more years?*

Yes
No

# Years*

# Months*

Previous Address

Street Address City State ZIP Code

Co-Borrower or 2nd Business Guarantor?*

Yes
No

Co-Borrower or 2nd Business Guarantor

Name*

First Middle Last

Birthdate*

Social Security #*

Phone*

Title*

% Ownership*

Email*

Address*

Street Address City State ZIP Code

Monthly Payment*

Own
Rent

Resided at address 5 or more years?*

Yes
No

Previous Address

Street Address City State ZIP Code

Equipment and Experience Info

Stock Number(s) of Truck(s) Needing Financing

Salesperson(s) You're Working With

Is this additional equipment?*

Yes
No

Explanation:

Current Fleet Size

# Tractors

# Trailers

# Trucks

Purchaser to drive truck?*

Yes
No

CDL Number*

Please enter your CDL Number

Driver Experience*

YRS

MOS

Owner/Operator Experience*

YRS

MOS

Do you have a trade in?*

Yes
No

Down payment amount*

What terms are you looking for?

Lease or purchase?*

Lease
Purchase

Product(s) to be hauled*

Comments?

References

Previous Employer	Contact Name	Phone	Fax	Email

Haul Reference	Future or Current Reference	Contact Name	Phone	Fax	Email	Account #

Equipment/Loan Reference	Contact Name	Phone	Fax	Email	Account #

Credit Application Agreement

The undersigned Customer ("Customer") hereby makes application for the extension of commercial credit to finance the purchase of certain motor vehicles from Jim Reed Truck Sales. ("Jim Reed Trucks Sales"). Customer authorizes Jim Reed Truck Sales to forward this application, together with any supplemental materials submitted by Customer, to others for consideration of credit extension. Jim Reed Truck Sales may receive from and disclose to others, including credit reporting agencies, information about the applicant's accounts and credit experience. Applicant authorizes such others to release to Jim Reed Truck Sales credit experience and account information regarding applicant. This shall be a continuing authorization for all present and future disclosures of account information and credit experience on applicant made by Jim Reed Truck Sales or any person requested to release such information to Jim Reed Truck Sales. Customer represents and warrants that the information disclosed herein, along with any and all supplemental information, including financial statements, tax returns, and balance sheets, are accurate and complete. Customer will provide immediate notice in writing to Jim Reed Truck Sales if and when any material changes occur in this information.

I agree to Jim Reed Truck Sales Credit Application Agreement

Signature*

Email

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

Finance Credit Form

Business

Owner Operator/Business Guarantor

Co-Borrower or 2nd Business Guarantor

Equipment and Experience Info

References

Credit Application Agreement

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