Credit Application Δ Step 1 of 4 25% Please include the following financial information with this application:(Required) 2 years of federal tax returns 3 months of interim financial statements File(Required) Drop files here or Select files Max. file size: 50 MB, Max. files: 2. Company OverviewCompany Name (as registered with the state)Company NameDBA:Physical Address:(Required) Street Address City State / Province / Region ZIP / Postal Code Mailing Address:(Required) Street Address City State / Province / Region ZIP / Postal Code Website Address Email(Required) Entity Type(Required) Sole Proprietorship S-Corp C-Corp LLC LLP Partnership Federal Tax ID(Required)Date of Incorporation: MM slash DD slash YYYY Nature of Business/Operations: Shareholders’ EquityNameTitleDate Joined% of Ownership Add RemoveCustomer Base/ContractsCompanyContactPhone% of Revenues Add RemoveCommercial Trade ReferencesReferenceContactPhoneAccount # Add RemoveCurrent FleetHow many trucks do you have in your fleet?(Required)This is my first truck(Required) Yes No Is this truck an addition or a replacement?(Required) Additional Unit Replacement Unit Have you ever had a repossession?(Required) Yes No Ever filed for Bankruptcy?(Required) Yes No If yes, please explain circumstances:Fleet Financing ReferencesFinancial InstitutionContactPhoneAccountBalance Add Remove Guarantors/Ownership InformationPrincipal Name(Required)Phone(Required)Email(Required)Home Address(Required)Social Security Number(Required)Date Of Birth(Required) MM slash DD slash YYYY Monthly Income(Required)Mortgage/Rent(Required) Own Rent Time at Residence:(Required)Guarantors/Ownership InformationPrincipal Name(Required)Phone(Required)Email(Required)Home Address(Required)Social Security Number(Required)Date Of Birth(Required) MM slash DD slash YYYY Monthly Income(Required)Mortgage/Rent(Required) Own Rent Time at Residence(Required)Guarantors/Ownership InformationPrincipal NamePhoneEmailHome AddressSocial Security NumberDate Of Birth MM slash DD slash YYYY Monthly IncomeMortgage/Rent Own Rent Monthly IncomeGuarantors/Ownership InformationPrincipal NamePhoneEmailHome AddressSocial Security NumberDate Of Birth MM slash DD slash YYYY Monthly IncomeMortgage/Rent Own Rent Monthly Income Commercial Banking InformationBank Name(Required)Contact(Required)Phone(Required)Account(Required)Check all that apply Checking/Savings Working Line of Capital Term Loans Mortgage I (We) authorize DTI Trucks or its designee(s), assignee(s), or any lending source to whom this application is submitted (“You”) to obtain, review or investigate all credit information, including but not limited to consumer credit reports, bank and trade references and accountant information for purposes of processing this lease credit application. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting account. All principals hereto agree that an electronic copy of this application may be treated as and considered the same as an original, including the signature(s) below. By providing my contact information, I agree to receive electronic communications from You. I (We) certify that the above information provided is true and correct. SignaturePrint Name First Date MM slash DD slash YYYY SignaturePrint Name First Date MM slash DD slash YYYY SignaturePrint Name First Date MM slash DD slash YYYY SignaturePrint Name First Date MM slash DD slash YYYY
