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CREDIT APPLICATION

Step 1 of 3

Company/Owner Details
Company Name*

For Sole Proprietors: use full name, first and last
DBA (if applicable)
Business Address*
Street Address City State ZIP Code

(No PO/APO)
Phone*
Business Type*
Federal Tax ID (If LLC or Inc)/ Social Security # (If Sole Proprietor)*

Tax ID if applicable, otherwise please input SSN if Sole Proprietor with no tax ID
State of Formation*
Date Established*
MM slash DD slash YYYY
Primary Business Vocation:*

Ex: Construction, Metal Recycling, Aggregate Hauling, General Freight, Heavy Haul
# of Heavy Duty Trucks*
# of Trailers
Number of years as owner/operator:
Number of years driving experience:

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Equipment Details
Equipment to Finance
Down Payment, if any
Business Details
Haul Reference
Business Start Date Contact Name Phone

Haul references should not include yourself or your business
Previous Financing
Current or previous financing oftrucks, tractors and trailers only
Lender Acct # Contact Name Phone
Who is your salesman?*
BUSINESS Credit Information: Authorization for Disclosure. Applicant hereby authorizes the release of credit information to Brazos Trailers from any source including credit bureau reporting agencies and applicant’s Bank, and further authorizes Brazos Trailers to refer this application and share such information with any other Brazos Trailers. I hereby represent that all of the information contained in this credit application is true, correct and complete. Applicant hereby authorizes Brazos Trailers to execute and file any UCC financing statements in its name upon approval of the application.
By (Signature) X*
Authorized Representative of Credit Applicant
Title*

Please Print
Name*

Please Print
Date*
MM slash DD slash YYYY
PERSONAL Credit Information: Authorization for Disclosure. By signing below, the undersigned individual (“Applicant”) who is either a principal of the credit applicant or a personal guarantor of the obligations, authorizes the release of credit information to Brazos Trailers from any source including credit bureau agencies, and further authorizes Brazos Trailers to refer this application and share such information with any other Financing Source. A consumer report may be requested in connection with this application and, upon written request, Applicant will be informed whether or not a consumer report was requested, and if such report was requested, provided with the name and address of the consumer reporting agency that furnished the report.
By (Signature) X
Guarantor #1 Authorized Representative of Credit Applicant
Name

Please Print
Date
MM slash DD slash YYYY
By (Signature) X
Guarantor #2 Authorized Representative of Credit Applicant
Name

Please Print
Date
MM slash DD slash YYYY
ECOA NOTICE: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract), because all or part of the applicant’s income derives from any public assistance, or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law is the Bureau of Consumer Financial protection, 1700 G Street NW, Washington DC 20006 and also the Federal Trade Commission, EqualCredit Opportunity, Washington DC 20580. If your application for business credit is denied or condition- ally approved, you have the right to a written statement of the specific reasons for the denial or the conditional approval. To obtain the statement, please contact Brazos Trailers within 60 days from the date you are notified of such denial or condition. We will send you a written statement of reasons for the denial within 30 days of receiving your request for the statement.
Consent*
I agree to the privacy policy.
By clicking "Submit", on behalf of themselves and the applicant, the applicant and the Owners/Partners/Members/Guarantors agree as follows:

They certify that all information provided is true, correct and complete and that the property leased or acquired with any credit provided will be used solely for business and commercial purposes. Providing email addresses authorizes Brazos Trailers to email information about financing, promotions, and other offers. The applicant and the Owners/Partners/Members/Guarantors of the applicant listed above recognize that their individual credit histories may be a factor in the evaluation of the applicant for the credit it is applying for and, thus, authorize Brazos Trailers or its designee to investigate their organizational and personal credit histories. This includes obtaining information from all sources including using their consumer credit reports in the credit evaluation and collection processes, and to update any such information periodically and, if the application for credit is approved, share such information with financing partners and professional advisors.
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Comments
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Business	Start Date	Contact Name	Phone

Lender	Acct #	Contact Name	Phone

Please complete all fields marked with an *

CREDIT APPLICATION

Step 1 of 3

Company/Owner Details

Guarantor Information

Equipment Details

Business Details

Previous Financing