Titled Equipment Application

Please fill out the form in its entirety.

Business Information

Applicant Type*

Legal Company Name*

Business DBA*

Address*

City, State, Zip*

Date Business Started*

/ /

Legal Business Entity*

Contact Name*

Email*

Business Phone #*

Federal EIN #*

Type of Industry*

Equipment Location (if Different from Above) Address

Principal(s) Information

How Many Principals are there?*

Equipment / Transaction Information

Equipment Type*

Equipment Cost*

Equipment Age*

How Many Trucks Currently In Fleet?*

How Many Trailers?*

Term Requested*

Do You Specialize In Long Haul or Short Haul?*

Long Haul across state lines, short haul in-state

Apportioned Plates On This Vehicle?*

Signatures

Delivery of this application bearing a facsimile signature shall have the same force and effect as if the application bore an inked original signature. I certify that the information contained in this file is true and accurate and authorize the lender or its designees to obtain credit, account history, employment, and related information for review.

Driver License Front*

Driver License Back*

Form W-9*

Business License*

Principal (1) Signature*

Principal (1) Signature Date*

/ /

Principal (1) Printed Name*

Finance Options

90 day Deferral

No payments for the first 90 days of your contract

Seasonal Skip Payments

Choose 3 consecutive months each year during your contract to skip your payments

Lease or Loan Products

EFA, $1 Buyout, Trac Leases & True FMV Leases available

Additional Working Capital

Finance a piece of equipment and qualify for 25% (or more!) working capital