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Chesapeake – (757) 485-4960
Manassas – (571) 921-1127
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Manassas – (571) 921-1127
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Chesapeake – (757) 485-4960
Manassas – (571) 921-1127
Call Now
Chesapeake – (757) 485-4960
Manassas – (571) 921-1127
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Chesapeake
Manassas
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Chesapeake
Manassas
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Ohio
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Puerto Rico
Rhode Island
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Tennessee
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Utah
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Vermont
Virginia
Washington
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Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
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State
ZIP Code
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Own/Rent:
CDL#:
Former Address (If at present address less than 2 years):
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
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Kentucky
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Maryland
Massachusetts
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Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
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State
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Phone Number:
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Year
State:
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Percent Owned
Title
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Is This Additional Equipment:
Yes
No
If Yes, Explain:
Purchaser to Drive Truck (Y/N):
Yes
No
Will This Truck Be Driven More Than 51% In California (Y/N):
Yes
No
Haul/Lease For The Past 5 Years (Start With Most Current)
Haul/Lease Details:
Haul Source
How Long Employed
Phone Number
Contact
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How Long in Business:
How Long as an Owner/Operator:
What Products Do You Haul?:
Truck/Trailer Credit - Past and Present
Number of Trucks Operating:
Number of Trailers Operating:
Is This Your First Time Financing Equipment?(Y/N):
Yes
No
Have You Had Any Of The Following? Bankruptcy/Repossession/Tax Liens:
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Repossession
Tax Liens
Explanation:
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Phone Number
Contact
Account #
Balance
Collateral
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Purchase or Lease Financing:
Do You Have A Trade In?(Y/N):
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No
Cash Down:
Consent
*
The undersigned Applicant ("Applicant") represents and warrants that the information provided herein is accurate and complete. Truck Enterprises, Inc., any of its' subsidiaries, designee or potential assignee (hereinafter collectively "TEI") may receive from and disclose to other persons, including credit reporting agencies, information about Applicant's accounts and credit experience and Applicant authorizes any person to release to TEI credit experience and account information on Applicant. This is a continuing authorization for all present and future disclosures of account information and credit experience on Applicant made by TEI or any person requested to release such information to TEI. Applicant will provide TEI prompt written notice of any material change in the information disclosed herein.
I agree to the above statement
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Date:
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Co-Applicant Signature:
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