::: Laredo Truck And Trailer :::

Partnership

Proprietorship

Nonprofit Org.

Corporation

Corporation Tax ID Number, If Applicable CorpTaxID

Primary Applicant

Full Name
License No.
		(With State + Expiration Date)
Date of Birth		Age
S.S. Number
Business Phone
Residence Phone

Spouse

Full Name
Date of Birth		Age
S.S. Number

Present Adddress

Address Line 1
Address Line 2
City / State / ZIP
How Long?		Years & Months
Own / Rent		Own Rent
Mortgage / Rent Paid To

Former Address

Address Line 1
Address Line 2
City / State / ZIP

Corporation Name
Incorporated In What State?
Date Of Incorporation
Date In Business
Principal
Principal Title
Principal
Principal Title

Name	Address

City	State	Phone	Relation


Name	Address

City	State	Phone	Relation


Name	Address

City	State	Phone	Relation


Name	Address

City	State	Phone	Relation

Company Name
Contact Name
Phone
Address
Position
How Long?

Company Name
Contact Name
Phone
Address
Position
How Long?

Company Name
Contact Name
Phone
Address
Position
How Long?

How Long As An Owner-Operator
Nature Of Business
		(Materials, Between What Points, Construction, Over-The_Road, Etc.)
Gross Monthly Income

Truck

Year / Make / Model
Engine
Transmission
Rears
Sleeper
Serial Number
Condition		Good Fair Poor
Title State
Months In Loan
Payment Amount
Amount Still Owed
Other Info

Trailer

Year / Make / Model
Length / Width / Height
Serial Number
Condition		Good Fair Poor
Title State
Months In Loan
Payment Amount
Amount Still Owed
Other Info

Examples: How To Fill Out This Section
Include:

Asstes - Real Estate, Savings Account, Trucks, Trailers, Autos, Loans
Liabilities - Credit Cards, Fuel Bill, Etc.

Description	Bank	Phone	Acct. No.

	Asset Value	Payment Amount	Amount You Owe

Description	Bank	Phone	Acct. No.

	Asset Value	Payment Amount	Amount You Owe

Description	Bank	Phone	Acct. No.

	Asset Value	Payment Amount	Amount You Owe

Description	Bank	Phone	Acct. No.

	Asset Value	Payment Amount	Amount You Owe

Description	Bank	Phone	Acct. No.

	Asset Value	Payment Amount	Amount You Owe

Have You Filed Bankruptcy In The Last 10 Years?	Yes No
Any Items Repossessed?	Yes No

The information given above is true and complete. Lender may receive from and dsclose to other persons, including credit reporting agencies, information about Applicant's accounts and credit experience and Applicant authorizes any person to release to Lender credit experience and account information on Applicant. This shall be a continuing uthorization for all present and future disclosures of account information and credit experience on Applicant made by Lender or any person requested to release such information to Lender.

  Today's Date

  Signed By

  Your Title

  Your Email Address

Please Print and Fax to:
(956) 791.5780

Disclaimer:
Email is not considered to be a completely secure medium for the transmission of sensitive information. Those who email credit application information do so at their own risk."