Infinity Equipment, Truck & Trailer Sales
901 McCarty / Houston, Texas 77029 / Mailing P.O. Box 96438 / Houston, Texas 77213-6438
713.675.6969 / Fax 713.675.4099 / Email: Sales@infinityequipment.com

CREDIT APPLICATION

CUSTOMER NAME:

STREET: CITY:

COUNTY: STATE ZIP

SOCIAL SECURITY: CDL#:

CDL STATE: CDL EXPIRATION: DATE OF BIRTH

HOME PHONE #: MOBILE PHONE #:

BUSINESS PHONE #:

OWN HOME RENT

HOW LONG AT THIS ADDRESS? YEARS MONTHS

PREVIOUS ADDRESS (IF LESS THAN 5 YEARS AT CURRENT ADDRESS)

STREET: DATES: FROM TO

CITY: STATE: ZIP:

SELF EMPLOYED OR BUYING BUSINESS NAME:

LEGAL NAME OF COMPANY:

PHONE#: CITY:

STATE: COUNTY: ZIP:

DATE OF INCORPORATION: STATE:

CORPORATION PARTNERSHIP PROPRIETORSHIP

LIST OWNERS OF CORPORATION AND SOCIAL SECURITY #'S

HAUL REFERENCE

ARE YOU A FIRST TIME BUYER: YES NO

TRUCK OR TRAILER TO WORK FOR:

CONTACT: PHONE #

EMPLOYED: YEARS MONTHS PURCHASE TO DRIVE: YES NO

IF YOU ARE SELF EMPLOYED, LIST TWO HAUL REFERENCES:

NAME: CONTACT #:

NAME: CONTACT #:

 

TOTAL YEARS IN TRUCKING: # TRUCKS OWNED

COMMERCIAL DRIVERS LICENSE#: STATE:

BASE PLATE IN WHAT STATE: TITLE IN WHAT STATE:

Bank

City State: Phone/Contact:

Account Numbers:
Checking: Savings: Other:

ASSETS
Cash On Hand/In Banks
VALUE
 LIABILITIES
(Company, City, State, Phone#, Account & A Contact)
In Banks: $ $ Accts. Payable/Monthly Charges:
On Hand $ $ $
ACCOUNTS RECEIVABLE:     Notes Payable $
FROM:   $   $
SAVINGS/CD's/IRA's: Credit Cards: $
Where: $ $
  $
REAL ESTATE Mtg. Holder:
Cost: $ $
When:      
Description:
TRUCK/TRAILER PURCHASES VALUE WHERE FINANCED AMOUNT OWED
YEAR/MAKE:
YEAR/MAKE:
YEAR/MAKE:
OTHER ASSETS VALUE OTHER LIABILITIES AMOUNT OWED
TOTAL ASSETS $ TOTAL LIABILITIES S
INCOME STATMENT   NET WORTH S
Profit: From: To:      
Business Gross Income: Other Income: Depreciation: Expenses: Operating:
         
CREDIT REFERENCES ON PAID MORTGAGES OR EQUIPMENT ACCOUNTS

AUTHORIZATION:

The undersigned has applied to Infinity Equipment, Truck & Trailer Sales or its assigns for extension of credit. This will be your authority and my request to release any information concerning personal or business credit standing, which may include but not be limited to, personal or business credit histories. Information to be released by telephone or fax.

By entering Social Security Number and License Number in this form, theapplicant authorizes release of all banking and credit information, both business and/or personal, requested by Infinity Equipment, Truck, & Trailer Sales. This form may be reproduced or photocopied and a fax copy should be as effective consent as this original that I have produced.

APPLICANT SIGNATURE

X DATE

CO-APPLICANT SIGNATURE

X DATE