Lease Application

For the purpose of obtaining credit from B94 Trucking Inc or establishing credit for future business transactions, We submit the information provided herein as accurate and complete. We agree to promptly notify B94 Trucking Inc of any significant changes to our financial circumstances or the financial status of our business.

DOT#

MC#

Legal Business Name

Select Business Type

Business Adress

Street Address

City

State

Zip code

Federal Tax ID

Email Address

Phone Number

Fax

year

Contact/Title

Owner Name

Social Security

Phone Number

Home Address

Street Address

City

State

Zip code

Birth Date

Principal 2 Name

Social Security

% of Ownership

Phone Number

Account

Bank Name

Account-Number

Name of Trade References

Phone Number

Contact Name

Name of Trade References

Phone Number

Contact Name

Currently Owned

Number of Tractors

Number of Trailers

Ever Filed Bankruptcy

Ever Had Goods/Vahicles Repossessed

Guarantor Address

Street Address

City

State

Zip code

Birth Date

Social Security

We recept notice in compliance with the federal equal credit opportunity act if applicable. The foregoing application has been carefully read (both printed and written matter) and is in all respects complete, accurate and truthful. This application is given for your sole use and information, and is not to be divulged to or used by anyone else provided, hereby authorizes the above named bank (s), trade and/or credit reference(s) to release such information as is necessary to establish credit with you. We further represent that said equipment shall be used for commercial purpose and shall not be used for any unlawful purpose.

Signature of Guarantor (Full Name)

Today

Signature of Guarantor (Full Name)

Today