Atkinson Truck Sales, Inc.
Please fax the completed application to 434-432-9774
Credit Application
APPLICANT:
Legal company name:
Proprietorship, partnership, corporation, other: FEI# (if any)
Address:
City: County: State: Zip:
Phone: Fax: Cell Phone:
Email: Website:
Equipment will be located at-Same as above: Other:
Type Of Business:
Time in business under current ownership: At this location:
PRINCIPALS:
Name: Social Security#:
Title: % of ownership: Home Phone:
Address & Zip Code:
Name: Social Security#:
Title: % of ownership: Home Phone:
Address & Zip Code:
EQUIPMENT TO BE FINANCED:
Dealer: Atkinson Truck sales, Inc. New/Used/Age: Equipment cost: $
BANKING REFERENCE: Contact:
City & State: Phone:
Type of Account: Account Number:
LOAN OR LEASE REFERENCE: Contact:
Account Number: City & State: Phone:
LOAN OR LEASE REFERENCE: Contact:
Account Number: City & State: Phone:
TRADE REFERENCE: Contact:
Account Number: City & State: Phone:
TRADE REFERENCE: Contact:
Account Number: City & State: Phone:
Federal reserve board regulatioins give applicants the right to request a written explanation of any declined application.