DTI Credit App .pdf

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Title: Microsoft Word - DTI Credit App
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Joe Hoover

DTI Trucks

Finance Manager
truckfinance@dtitrucks.com

8955 West 44th Avenue
Wheat Ridge, CO 80033

Office (303) 524‐3820
Fax (303) 524‐3864

CREDIT APPLICATION
Corp or Individual's FULL Legal Name:
Trade Name / D.B.A.:

Type of Current Business / Trade:

Business Address:

Principal Officers & Title:

Company Website:
Phone:

Fax:

Corp
LLC

S-Corp
General Partnership
Sole Proprietorship

LLP /

BUSINESS INFORMATION
State of Incorp / Org:

Date of Incorp / Org:

Corp ID # or Federal Tax ID (EIN):

# of Years in Current Business:
# of Years of Industry Experience:

Prior Experience With Who? Company Name & Industry / Trade:

Vehicle: (circle one)

Ever Filed Bankruptcy? Y
If So, Year:
Why?

New / Additional or Replacement
Vehicles in Fleet:

/N

Ever Had Repossession? Y
If So, Year: Why?

/N

GUARANTORS / OWNERSHIP INFORMATION
Parent Company:

Address:

Principal Name:

Home Address / Phone:

Social Security #:

Date of Birth:

Mortgage / Rent: $

Email:
Ownership %:

Owner Operator: Y

Monthly Income:
Circle: Own

Time at Current Residence:

Principal Name:

Home Address / Phone:

Social Security #:

Date of Birth:

Mortgage / Rent: $

Ownership %:

Home Address / Phone:

Social Security #:

Date of Birth:

Mortgage / Rent: $

/ Rent

Email:
Owner Operator: Y

Monthly Income:
Circle: Own

Time at Current Residence:

Principal Name:

/N

/N

/ Rent

Email:
Ownership %:

Owner Operator: Y

Monthly Income:
Circle: Own

Time at Current Residence:

/N

/ Rent

BANKING INFORMATION
Contact: Name / Phone:

Bank Name:
Account #:

Account #:

Checking
Working Capital Lines
Term Loans
MONTHLY OBLIGATIONS / COMMERCIAL OR TRADE REFERENCES:

Type Relationship's): Circle ALL that Apply:
Vehicle / Installment Debt:

Alimony / Child Support:

Credit Cards:

Any Taxes Currently Past Due?

Mortgage

Liens:

Y/N

Amount:

Reference:

Contact: Name / Phone:

Account #

Reference:

Contact: Name / Phone:

Account #

I (We) authorize DTI Trucks or its designee(s), assignee(s), or any lending source to whom this application is submitted (“You”) to obtain, review or
investigate all credit information, including but not limited to consumer credit reports, bank and trade references and accountant information for
purposes of processing this lease credit application. Such authorization shall extend to obtaining a credit profile in considering this application and
subsequently for the purposes of update, renewal or extension of such credit or additional credit and for reviewing or collecting the resulting
account. All principals hereto agree that an electronic copy of this application may be treated as and considered the same as an original, including
the signature(s) below. By providing my contact information, I agree to receive electronic communications from You. I (We) certify that the above
information provided is true and correct.

Signature

Print Name

Date

Signature

Print Name

Date


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