Credit Application Form

Double A Trailer Sales

Credit Application
Applicant Information
Name

First NameLast Name
Social Security Number
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Trade / Company Name
Phone

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

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Business Type
Date of Incorporation

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
State of Incorporation
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Current Residence Type
How long have you lived at your current address?
Previous Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous Residence Type
How long did you live at your previous address?
Current Fleet Size
Number of Tractors / Trucks
Number of Trailers
Owner/Operator Time
Years and months
Have you ever filed bankruptcy?
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. *
Should be Empty:

Double A Trailer Sales