COMPANY NAME

BUSINESS ADDRESSS

BUSINESS EMAIL

BUSINESS PHONE

TAX ID #

YEARS IN BUSINESS

NUMBER OF TRUCKS OWNED:

NUMBER OF TRAILERS OWNED:

First Name

Last Name

Current Address

Housing:
RentOwn

Previous Address (if less than 5 years)

Time @ Current Home

Monthy Payment

Social Security #

DL # / State

Date of Birth

Email

Phone Number

Gross Monthly Income

TERMS
Signatures: I certify that everything I have stated in this application and on any attachments is correct. You may keep this application whether or not it is approved. By signing below, I authorize RK Truck Sales and its affiliates, successors, and assignes to check my credit and employment history and to answer questions others may ask you about my credit record with you. I understand that I must update credit information at your request if my financial condition changes.

DRIVER LICENSE

3 MO BANK STATMENTS

SIGNATURE