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2003 - W-900L

475-CAT
18 speed
156,000 miles

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Drivers4hire.com Leasing And Financing Application
By completing this form Drivers4hire.com can find you a new or used truck and also locate financing. Please be as complete as possible with the information you provide. If you are experiencing problems with this form or any part of this website please contact us immediately. 1-877-223-2988 Toll Free
* Means required item
Drivers Information
First Name*
Middle Name
Last Name*
Home Phone*
Cell Phone
Address 1*
Address 2
City*
State*
Zip*
E-mail address
DOB:*
SSN#:*
Years at Present Address:*
Emergency Contact:
Emergency Telephone:
How did you here about us?
Residency Status?
Own/Buying Renting Mobile Home Live with Relatives
Employment Information
Truck(s) to be leased/work for:
Contact:
Phone:
Employed years and months:  
Total years in trucking:
Assets (Making Payments On)
Name Contact City, State Phone
Down payment How much? Outstanding child support? Bankruptcy
Bankruptcy Type Date of Bakruptcy Include tractor? Ever own a tractor
Tax Liens Legal Actions Judgements Lawsuits pending
Reposssession    

Please have a Drivers4hire.com representative contact me with information on locating a new or Used Truck.

For the purposes of procuring and maintaining credit, I the undersigned submit the foregoing statement and the information, including any supplemental sheets, as being a full, true and correct statement of my financial condition on the date stated below. I certify that the information in this application is true and correct to the best of knowledge. I certify that the vehicles leased and or financed will be used exclusively for business or commercial purposes. I understand that this application will be retained whether or not it is approved. "Drivers4hire.com, LLC." is authorized to obtain information from and share information with any designated finance companiesrelating to this application and review of my credit. I further authorize you "THE FINANCE COMPANIES" or your designee to verify my employment history, check my credit with credit reporting agencies and or other sources whether listed or not listed on this application and to answer questions about your credit experience with me. The undersigned agrees to notify "The Finance Company" immediately in writing of any material unfavorable change in my financial condition. We hereby grant permission to all the above creditors to release our account information to "The Finance Company". We/I hereby authorize Drivers4Hire.com, LLC. to release and forward this application as it may find needed. We/I hereby release Drivers4Hire.com, LLC. and "ANY"company networking with Drivers4Hire.com, LLC. We/I hold Drivers4Hire.com, LLC. Harmless of"legal actions, claims, disputes, disagreements and or warranties arising from finance, inquiries or otherwise.


Submission of this form electronically agrees to the above terms and conditions of this application.

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