Finance Application

Step 1 of 3

OWNER or COMPANY INFORMATION

Company Name or Owner if INDIVIDUAL

Tax I.D. or Social Security #

Office Phone

Address

Street Address City State ZIP Code

Cell Phone

Office Fax

# Employees

Email Address

Business Description

Years of Experience

in business

of ownership

truck driving

Equipment Ownership

#HD Trucks

#MD Trucks

# Trailers

Heavy Equipment

Total

#Financed

# Clear Title

Majority Owner

Name

% of Stock Owned

S S Number

Date of Birth

Married

Dependents

Address

Street Address City State ZIP Code

Own/Rent Home

Length of Residence

Other Income

Personal Net Worth

COL Number

Home Phone

Cell Phone

Pager

Co-owner or Spouse

Name

% of Stock Owned

S S Number

Date of Birth

Work Phone

Cell / Pager

Address

Street Address City State ZIP Code

Employer Address

Street Address City State ZIP Code

Income

Term

Have any of the above: filed bankruptcy, had a repossession, owe any delinquent taxes (attach explanation)

Filed Bankruptcy

Year

Status

Repossession

Year

Taxes

Year

HAUL REFERENCE

Company

Contact

First Last

Term

Phone 1

Phone 2

% of revenue

Company

Contact

First Last

Term

Phone 1

Phone 2

% of revenue

TRUCK FINANCE REFERENCES

Name

Type

Account Number

Original Amount / Limit

Balance

Phone

Contact

First Last

Name

Type

Account Number

Original Amount / Limit

Balance

Phone

Contact

First Last

Name

Type

Account Number

Original Amount / Limit

Balance

Phone

Contact

First Last

Bank

Bank Name

Address

Street Address City State

Phone

Contact

First Last

Account #

Average Balance

Insurance

Agency

Address

Street Address City State ZIP Code

Phone

Fax

Contact

First Last

Carrier

I / We certify that the above information is true and accurate to the best of my/our knowledge. I / We hereby authorize our banks, trade references and financial institutions to release credit information to White's International Trucks and its Assigns even if by fax or copy of this document. I further authorize White's International Trucks and its Assigns to obtain other credit information including D&B Reports and Credit Bureau Reports on the business and also any guarantors as individuals

Applicant or Guarantor Signature

Date

Salesman

First Last

Store Location

Truck Unit #

Year

Make

Model

VIN

Price

Down Payment

Term of Loan

OWNER or COMPANY INFORMATION

Years of Experience

Equipment Ownership

Majority Owner

Co-owner or Spouse

Have any of the above: filed bankruptcy, had a repossession, owe any delinquent taxes (attach explanation)

HAUL REFERENCE

TRUCK FINANCE REFERENCES

Bank

Insurance

Quick Links

Locations

Social media