Owner Operator Credit Application Form
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1
2.
Daimler
Owner Operator Credit Application
Truck Financial
Type of Application:
Business
Individual
New
Used
Salesperson’s Name: ____________________________
Dealer Name:
Dealer Phone:
Dealer Fax:
INDIVIDUAL/PARTNERSHIP INFORMATION:
st
1
Time Buyer/Borrower
Previous Finance Exp.
Existing Equipment (# of units) Trucks:
Tractors:
Trailers:
Full Name:
Social Security Number:
Date of Birth:
Primary Phone Number
Pager Number
Cell Phone Number
E-Mail Address
Present Physical/Mailing Address:
City:
County:
State:
Zip:
How Long at Present Address?
Rent
Own
Live with relatives
Monthly Payment:
Years:
Months:
Previous Address (If less than 2 years)
Co-Buyer
Co-Buyer’s SSN:
Co-Buyer’s Phone Number:
Present Physical Address:
City:
County:
State:
Zip:
Employer
Time on job
Income
NEAREST RELATIVES/PERSONAL REFERENCES NOT LIVING WITH YOU:
Name
Address
City
State
Zip
Phone
Name
Address
City
State
Zip
Phone
CORPORATION/LEGAL ENTITY INFORMATION (If Applicable)
Exact Legal Name of Corporation/Legal Entity:
Inc.
LLC
Partnership
Federal ID#
Year of Organization
Principal Officer
Social Security Number
Title
% Owned
State Incorporated
CURRENT EMPLOYMENT INFORMATION
Total Years of Driving Experience
Years as Owner Operator
Years as Company Driver
Name:
City:
State:
Phone:
Contact
Years at Current Employer
Months
Income
Company Driver
Owner Operator
Other
Other Annual Income
Source
Amount
FUTURE EMPLOYMENT
Name
City/State
Phone Number
Contact
Monthly Miles
Monthly Revenue
Paid
/mile
% of Gross
Products to be Hauled
Commercial DL#
State
PREVIOUS EMPLOYERS
Name
City
State
Phone Number & Contact Name
How Long?
yrs
mts
Name
City
State
Phone Number & Contact Name
How Long?
yrs
mts
Name
City
State
Phone Number & Contact Name
How Long?
yrs
mts
Trucks/Trailers Owned
Lending Institution
City/State
Phone #
Account #
Description of Collateral
TFFF2396 (09/29//2011)
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Parent category: Business