Personal Credit Application

Name

MC #

Address

City

States

Zip Code

Phone Number

Homeowner?

Yes No

Current Fleet Info:

How many Tractors?

How many Trailers?

HAUL REFERENCES: (5 Years) :

First Time Buyer?

First Time Buyer

Yes No

Total Years Driving Experience

Current Employer

City, State

Phone Number

Contact Name

# of Years

Previous Employer

City, State

Phone Number

Contact Name

# of Years

Previous Employer

City, State

Phone Number

Contact Name

# of Years

FINANCE REFERENCES

Reference #1

Truck #1

Finance Company

Reference #2

Truck #2

Finance Company

RELEASE: I hereby authorize Eva Sales and its representatives or assigns to obtain and disclose any personal or business credit information or ratings—by telephone, email, or fax—as needed. This includes accessing individual consumer credit reports, which may be taken into account when making credit decisions. I certify that, to the best of my knowledge, all information provided herein is accurate.

Signature

Date