GTC Credit Application Form

Personal Information: ▼

Name:* required

DOB:* required

Social Security:* required

Address:* required

Telephone:* required

Email:* required

Home:* required

Monthly Home Payment:* required

Business Information: ▼

Business Name:

E.I.N.:

Business Address:

D.O.T.#:

Formation:

State Formed?:

Years in Business:* required

Equipment Owned: (# of Trucks / Trailers):* required

Hauling Reference: ▼

Company Name:* required

Telephone:* required

Years Doing Business:

Materials Hauled:

Equipment: ▼

Make:

Model:

Condition:

Color:

Rim Type:

Rim Size:

Tarp:

Plates:

Term Requested:

Down Payments $:

Sales Person:

How did you hear about us?:* required

By signing below, the undersigned submits the above information for the purpose of obtaining credit and represents that all such information is true, complete, and accurate. By signing below, each of the undersigned individuals authorize Guerra Truck Center, LLC and its affiliates, successors, and assigns (collectively, "Bank") to obtain consumer credit reports relating to their individual credit history and/or creditworthiness in connection with: (a) this credit application by the applicant identified above ("Applicant"); (b) any guaranty by the undersigned of the debts, liabilities or obligations of Applicant to Bank; (c) Bank's periodic review of any credit extended by Bank to Applicant, or any guarantee of thereof by the undersigned; (d) any collection action with respect to any credit extended by Bank to Applicant, or any guarantee thereof by the undersigned; and (e) any other legitimate purpose. If Bank declines this credit application, this consent shall also extend to any prospective credit provider to which Bank may refer such application.