Credit Application Form

Double A Trailer Sales

Credit Application
Applicant Information
Name*

First NameLast Name
Social Security Number*
Date of Birth*

MonthDayYear
Date
Trade / Company Name*
Phone*

Area CodePhone Number
E-mail
Federal ID/EIN*
Business Start Date*

MonthDayYear
Date
Business Type*
Date of Incorporation*

MonthDayYear
Date
State of Incorporation*
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Current Residence Type*

OwnRent
How long have you lived at your current address?*

0-1 Year1-2 Years3-4 Years5+ Years
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Residence Type

OwnRent
How long did you live at your previous address?

0-1 Year1-2 Years3-4 Years5+ Years
Current Fleet Size
Number of Tractors / Trucks*
Number of Trailers*
Owner/Operator Time*
Years and months
Have you ever filed bankruptcy?*

YesNo
If you have ever filed bankruptcy, date and reason

References
Hauling / Work Reference #1*
Reference #1 Contact*
Reference #1 Phone Number*

Area CodePhone Number
Hauling / Work Reference #2*
Reference #2 Contact*
Reference #2 Phone Number*

Area CodePhone Number
Equipment Finance References
Finance Company #1*
Company #1 Phone Number*

Area CodePhone Number
Finance Company #2*
Company #2 Phone Number*

Area CodePhone Number
Guarantor Information
Guarantor Name*

First NameLast Name
Social Security Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I hereby agree that the information given is true, accurate and complete as of the date of this application submission. **

YES
Should be Empty:

Double A Trailer Sales