American Trucks and Equipment
Secure Loan Application

Primary Borrower Information

Loan Information

Partnership Proprietorship Nonprofit Org. Corporation

Personal

(CA,NY, etc.)
(MM/DD/YYYY)
/ /
- -
Years
Months
Own Rent
per month

Corporation Information

/ /
/ /

Nearest Relative Not Living With You

Employment

Years

Trade-In Information

Good Fair Poor
Good Fair Poor

Vehicle Purchase Information

Truck Trailer

Banking Information

Yes No
Yes No

Signature Line Date:

/ /

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.