Business Credit Application

Legal Business Name:

Business Type:

Business Address:
City, State, Zip

Federal Tax ID Number:

E-mail Address:

Phone Number:

Fax Number:

Business Start Date:

Website:

Principal 1 Name:

Social Security Number:

% of Ownership:

Phone Number:

Home Address:
City, State, Zip

Birthdate:

Principal 2 Name:

Social Security Number:

% of Ownership:

Phone Number:

Home Address:
City, State, Zip

Birthdate:

Bank Name:

Loan or Line of Credit:

Phone Number:

Fax Number:

Person to Contact:

Name of Equipment Lenders
Account Number
Phone Number
Contact Name

Name of Equipment Lenders
Account Number
Phone Number
Contact Name

Name of Equipment Lenders
Account Number
Phone Number
Contact Name

Currently Owned:
Number of Trucks/Tractors
Number of Trailers
Number of Other

Ever Filed Bankruptcy?
Yes

No


Date:

Chapter:

Ever Had Goods/Vehicles Repossessed?
Yes

No


Date:

If Yes, Please Explain.

Guarantor:

Address:
City, State, Zip

Birthdate:

Social Security:

I/We acknowledge receipt of 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, however, that the undersigned hereby authorizes the above named bank(s), trade and/or other 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 a commercial purpose and shall not be used for any unlawful purpose.

Electronic Signature of Applicant:

Date:

I/We acknowledge receipt of 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. However, that the undersigned, a guarantor, hereby authorizes and consents to Navistar Financial Corporation, Navistar Leasing Company and/or Harco Leasing Company, Inc. requesting my credit report.

Electronic Signature of Guarantor:

Date:


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