Let’s work together.

Take the first step toward ownership by completing the form below. Have questions? Contact our team for assistance.

Company Name

Company Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Tax ID/Employer Identification Number

Primary Product Shipped

Years in Business

Approximate Annual Revenue

FLEET MANAGEMENT CONTACT

Name

First Name

Last Name

Phone

(###)

###

####

Location

IF DIFFERENT FROM COMPANY ADDRESS ABOVE

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

BILLING/AP CONTACT

Name

First Name

Last Name

Phone

(###)

###

####

Location

IF DIFFERENT FROM COMPANY ADDRESS ABOVE

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

TRAILERS INTERESTED IN FINANCING THROUGH ROLLING STOCK

Make

Model

Approximate Purchase Price

Is this a sale/leaseback from your existing fleet?

Yes

CURRENT TRUCK FLEET SIZE

Percent Rented

Percent Owned

Percent Owner/Operator (other)

CURRENT TRAILER FLEET SIZE

Percent Rented

Percent Owned

INSURANCE CARRIER

Primary Insurance Contact Name

First Name

Last Name

Primary Insurance Contact Phone

(###)

###

####

BANKING REFERENCE

Bank Name

Primary Banking Contact

First Name

Last Name

Phone

(###)

###

####

TRADE CREDIT REFERENCE

Company Name

Company Contact

First Name

Last Name

Phone

(###)

###

####

MUST AGREE TO THE FOLLOWING

Do you agree to use electronic signatures for all documents?

Yes

Do you agree to use ACH for all payments due if approved?

Yes

FOR PERSON SUBMITTING APPLICATION

Name

First Name

Last Name

Phone

(###)

###

####

Let’s work together.

Mailing Address

Contact