Truck Source Inc.
Secure Loan Application

Primary Borrower Information

Loan Information

Personal

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per month
Years
(CA,NY, etc.)
(MM/DD/YYYY)

Employment

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Years
(numbers only)
per month

Consent

I represent and agree that (i) I am signing individually (if I am an Applicant indicated above), (ii) either I or another signer below is authorized and is signing on behalf of each entity that is an Applicant indicated above, and (iii) the information contained in this Credit Application is true, correct and complete. The following authorizations (i) apply to this Credit Application and subsequently for purposes of extending, reviewing, updating, and collecting credit; and (ii) are granted to the dealer receiving this Credit Application (“Dealer”) and any financial institution or other potential creditor to which this application is referred (each a “Financing Source”). A copy of these authorizations shall be valid as the original.
I (individually and on behalf of any entity, as the case may be) hereby authorize: (i) Dealer and each other Financing Source to refer this Credit Application to, and share any credit information with, any other Financing Source; (ii) any Financing Source to request and obtain, and any credit reporting agencies, Applicants’ banks or other third parties to provide, consumer reports, background checks and credit and other information regarding any Applicant or me individually; and (iii) any Financing Source to execute and file UCC financing statements covering the Applicant’s vehicles and/or other intended and related collateral, in anticipation of approval and extension(s) of credit.

Vehicle Information

Down Payment

Trade-In Details

Haul References

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Applicant Signature

(type your name)

By submitting this application, I certify that all information herein is true and complete. I agree I am providing this information to the dealer identified in this application and acknowledge that my information may be shared pursuant to the dealer’s privacy policy, if applicable. I hereby authorize this dealer, and any financial institution engaged as a service provider by this dealer, to retain this application and to check and verify my credit, employment and salary history. By submitting this application, I acknowledge I am authorizing this dealer to check my credit.