Specialty Truck Financing

BUSINESS INFORMATION *Required fields
*Company Name:
*Business Phone:
*Business Fax:
*Physical Address:
*City:
*Zip Code:
*Years Under Same Ownership:
*Type of Business:	Corporation Partnership Proprietorship Municipality Nonprofit LLC
*Federal I.D. No.:
*Date of Incorporation/Organization:

PERSONAL INFORMATION Include all owners to account for 100% of company ownership
Primary Contact: (First and Last Name)
*Title:
*Ownership %
*SSN:
*Home Phone:
*Business Phone:
Alternate Phone:
*E-mail Address:
*Home Address:
*City:
*State:
*Zip Code:

EQUIPMENT INFORMATION
Equipment Description
*Quantity:
*Price:
*Cab & Chassis:
*Equipment Body:
*YEAR
*MAKE
*MODEL
Serial #

*Location where equipment will be based (if different from above):	Business Address Home Address Other (please describe below)
Address:
City:
State:
Zip Code:

Equipment Seller
*Name:
*Address:
*City:
*State:
*Phone:
*Contact Name:
Comments
*Please enter all pertinent information about your company that that will help us in making a quick approval for your financial request.
The Applicants represent and warrant that all credit and financial information submitted to GLOBAL FINANCIAL SERVICES is true and correct and that Global Financial Services may obtain any credit information necessary pertaining to this application. Submitting this questionnaire is equivalent to a signature.