Credit Application | Proven Truck & Equipment

01

Applicant Information

Tell us about your business.

Company Name *

DBA Name (if different)

Physical Address *

Federal Tax ID / EIN *

Website (optional)

Year Business Started *

Years Under Current Ownership

Business Phone *

Primary Contact *

Contact Email *

Contact Phone

Type of Business *

Annual Revenues *

02

Principals / Owners

Principal 1 is required. Add up to two more owners if applicable.

Principal 1

Name *

Email *

Title *

% Ownership *

Phone *

Address (City, State & Zip) *

SSN *

🔒 Used only for a credit decision, never shared beyond our lender partners.

Principal 2 optional

Name

Email

Title

% Ownership

Phone

Address (City, State & Zip)

SSN

Principal 3 optional

Name

Email

Title

% Ownership

Phone

Address (City, State & Zip)

SSN

03

Equipment Information

What are you looking to finance?

Equipment Description *

Equipment Cost *

Vendor *

04

Authorize & Sign

Important — please read before signing.

The undersigned represents that all information provided with this Application is true and correct and hereby authorizes Lessor/Secured party to obtain from third parties, including Applicant's bank, information it deems necessary to arrive at a decision regarding this application. By signing below, the undersigned individual(s) as principal of and/or guarantor for the applicant, authorizes Lessor/Secured party, its designee, assigns or potential assigns, to review his/her personal credit profile provided by a national credit bureau in considering this application and for the purpose of update, renewal, or extension of credit to the Applicant or the collection of any resultant accounts. I authorize all deposit, borrowing, financial and trade information to be released to Lessor/Secured Party by telephone or fax. A photocopy or fax of this authorization shall be valid as the original. To help fight terrorism and money laundering, the information you provide may be verified to allow us to identify you.

Owner 1 Signature required

Name *

Date *

Signature (type full name) *

Owner 2 Signature optional

Name

Date

Signature (type full name)

Owner 3 Signature optional

Name

Date

Signature (type full name)

I have read the authorization above and agree to its terms on behalf of the Applicant.

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