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TRUCK PURCHASE CREDIT APPLICATION

PERSONAL INFORMATION

NAME
First Name
Last Name
Social Security Number
Date of Birth
Marital Status Married
UnMarried
Separated
E-Mail

Number of Dependents

ADDRESS
Street
City
State
ZipCode
Phone No.
How long at this address? Yrs
How long in the area? Yrs
SPOUSE'S DETAILS
First Name
Last Name
Social Security Number
Date of Birth
Spouse's Employer
Position Held
How long? Yrs
Income per year $
NEAREST RELATIVE NOT LIVING WITH YOU
NAME 1
ADDRESS
RELATIONSHIP
NAME 2
ADDRESS
RELATIONSHIP
Have you ever taken bankruptcy? No      Yes - Explain
Are you a defendant in any legal action? No      Yes - Explain
Have you ever had any item repossessed? No      Yes - Explain

EMPLOYMENT HISTORY FOR LAST FIVE YEARS ( Present or Last Employer First )
  COMPANY NAME PHONE POSITION HELD HOW LONG?
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More

BANK REFERNCES
  NAME CITY STATE ACCOUNT NUMBER
1 .
2 .
SALES PERSON INFORMATION
Have you been working with Fleet Truck Sales Representative?
If yes, please fill in the information.

First Name Last Name
Location


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