Loan Financing Application

Application Type *

Individual Business

Salesman

Applicant Details:

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Phone Number *

Email *

Date of Birth *

SSN *

CDL

Yes No

Years Driving (CDL)

Number of Years in Industry

Current Vehicles

Number of Trucks/Tractors Currently Owned *

Number of Trailers Owned *

Were These Financed? *

Yes No

Driving Experience and/or Haul References (2 years min. required)

1. Reference:

Company *

Years *

Phone *

Contact Name *

2. Reference:

Company *

Years *

Phone *

Contact Name *

Co-Borrower Details

Co-Borrower First Name *

Co-Borrower Last Name *

Co-Borrower Address *

Co-Borrower City *

Co-Borrower State *

Co-Borrower Zip Code *

Co-Borrower Phone *

Relationship to Applicant *

Co-Borrower DOB *

Co-Borrower SSN *

Authorize Background Check *

By clicking here I authorize SelecTrucks of Houston to investigate my credit, obtain credit reports, contact any of my current or former creditors to verify any information contained herein or received in connection with this Authorization or the accompanying credit application which you deem relevant to the possible extension of credit to me and release information about your credit experience with me as the law permits, and use written, verbal, and electronic means to contact me, including, without limitation, manual calling methods, prerecorded or artificial voice messages, text messages, e-mails and/or automatic dialing systems. Such means of contact may include use of an e-mail address or any telephone number I provide, now or in the future, including a cellular phone or other wireless device number, regardless of whether I incur charges as a result.

Digital Signature *