Central Arizona Truck and Trailer Sales

ERIC BUSCH FAX: 866-225-0829 CELL: 480-286-5475 EMAIL: ERICBUSCH@AZTRUCKS.NET 1611 S 59th Avenue Phoenix, AZ 85043

Credit Application

Application for credit under: Individual Partnership Corporation S Corp LLC

Individual/Guarantor Information: US Citizen YES NO Other_______________

Name ______________________________ Social Security # ___________________ Birth Date ____________

Address: _______________________________________________ Email Address:_________________________

____________________________________________________________________________________________(City) (State) (Zip Code) (County)

Home Phone __________________ Business Phone _________________ Cell Phone _________________

Renter Homeowner CDL YES NO Years as Owner/Operator _____ Years Driving Experience _____

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Business/Corporate Information: (if applicable)

Name of Company __________________ ______ Federal Tax ID# _____________________

State of Incorporation: Date of Incorporation: Number of years in business:

Address: ________________________________________________________________________________

_____________________________________________________________________________________________(City) (State) (Zip Code) (County)

Guarantor Title_________ ___ % of Ownership ______

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Haul References: (Need Complete Info- Do not put self unless you manufacture and deliver your own products)

Nature of Business Operations: Long Haul Local Regional

Name Phone Number Contact

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Equipment Finance References: (List present or past finance references or designate paid cash)

Finance Company/Cash Phone Original Balance Present Balance Collateral (Year, Make, Model)

Fleet Size # of Units

Bank Name/Balance Checking Savings Bank Name/Balance Checking Savings

By signing below, each undersigned individual(s), who is either a principal of the credit applicant listed below or a personal guarantor of its obligations, provides written instructions to Central California Truck and Trailer Sales, LLC, its designee, nominees or assignees or potential assignees, authorization to review his or her personal credit profile from a national credit bureau. Authorization is also granted to Central California Truck and Trailer Sales, LLC, its designees, nominees or assignees or potential assignees to obtain business credit reports, bank and trade references, provided to Central California Truck and Trailer Sales, LLC or to its affiliates and to review any provided financial statements. Such authorization shall extend to obtaining a credit profile in considering the application of the credit applicant and subsequently for the purposes of update, renewal or extension of such credit and for reviewing or collecting the resulting account. A photo static or facsimile copy of this authorization shall be valid as the original.

Applicant: Co-Applicant/Guarantor: ________________________________ Date: Date:

Tractors (Over the Road)

Trucks (Bobtail)

Trailers

DBA, (if applicable)________________________________

Authorization to Pull Credit Report

By signing below, I/We hereby authorize Central California Truck and Trailer Sales, LLC to obtain a consumer credit report through a credit reporting company chosen by (“CCT&TSLLC”).

I/We understand and agree that “CCT&TSLLC” intends to use this consumer credit report for purposes of evaluating my/our financial readiness to purchase equipment.

I/We understand that this credit report will be retained on file at “CCT&TSLLC” and that the information will not be disclosed to anyone without my prior written consent.

If the permission being granted is received electronically, my/our typed name(s) below represents said authorization.

______________________ ____________________ __________

Signature Print Name Date

______________________ ____________________ __________

Signature Print Name Date

______________________ ____________________ __________

Signature Print Name Date