Atkinson Truck Sales
Credit Application
Subject To Approval
* Required
Salesmen:   Print Blank Credit Application
Applicant Information
*Name:
*Date Of Birth:
*SSN:
*Phone:
*Current Address:
*City:
*State:
*Zip Code:
*(Please Select One)
Own: Rent:
*Monthly Payment Or Rent:
*How Long?
# Of Fleet Maintained Trucks:

Previous Address:
City:
State:
Zip Code:
(Please Select One)
Owned: Rented:
Monthly Payment Or Rent:
How Long?
   
Employment Information
*Current Employer:
*Employer Address:
*How Long:
*Phone:
E-mail:
Fax:
*City:
*State:
*ZIP Code:
*Position:
*(Please Select One)
Hourly: Salary:
*Annual Income:

Previous Employer:
Address:
How Long?
Phone:
E-mail:
Fax:
City:
State:
ZIP Code:
Position:
(Please Select One)
Hourly: Salary:
Annual Income:

Name Of A Relative
Not residing With You:


Address:

Phone:
City:
State:
ZIP Code:
Relationship:
   

Co-Applicant Information If For A Joint Account
Name:
Date Of Birth:
SSN:
Phone:
Current Address:
City:
State:
Zip Code:
(Please Select One)
Owned: Rented:
Monthly Payment Or Rent:
How Long?
 

Trade References
*Name:
*Address:
*Contact:
*Phone:
Email:
Fax:
*City:
*State:
*Zip Code:
Name:
Address:
Contact:
Phone:
Email:
Fax:
City:
State:
Zip Code:

Loan Or Lease References
Reference:
Address:
Phone:
City:
State:
Contact:
   
Reference:
Address:
Phone:
City:
State:
Contact:
   
Authorization
* "By checking this box, we hereby authorize the release of all credit information, including loans, leases, checking, savings, trade references, and personal credit history, pertaining to the company, its principals, and the people listed below, to Atkinson Truck Sales (and its designee or assignee). Such Authorization shall extend to subsequent updates for credit or collection purposes. Each undersigned individual(s), who is either a principal of the credit applicant listed below or a personal guarantor of its obligations, provides written instruction to Atkinson Truck Sales or its designee (and any assignee or potential assignee thereof) authorizing review of his or her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the application of the credit applicant and subsequently for the purpose of update, renewal or extension of such credit and for reviewing or collecting the resulting account. All of the people signing below are 18 years or older. A photostatic or facsimile copy of this authorization shall be as valid as the original."
*Digital Signature Of Applicant:
*Date:
09/24/2018
Digital Signature Of Co-Applicant, If For A Joint Account:
Date:
09/24/2018
Subject To Approval
*Required

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