button: home
button: inventory listings
button: contact us
button: location
button: credit application
Name:
Address:
Home Phone:
Individual
Partnership
Corporation
Business Address:
Business Phone:
Type of Business:
Have you ever financed with Navistar Financial Corporation?
Yes No
IF INDIVIDUAL: COMPLETE THIS SECTION, OTHERWISE PROCEED TO TRADE REFERENCES SECTION
Date Of Birth:
Marital status:
Married
Unmarried
Separated
No. of Dependents:
Former Residence:
Own Home: YesNo
Drivers License/CDL #:
Expires:
State:
Social Security #/TX ID:
Nearest Relative Not Living with Me:
Address:
Phone #:
Name of Employer:
Address:
Phone #:
Position:
Number of Years:
Salary:
Spouse Employed By:
Address:
Position:
Number of Years:
Salary:
Other Income:
Source of Other Income:
INCOME FROM ALIMONY, CHILD SUPPORT OR SEPARATION MAINTENANCE PAYMENTS NEED NOT BE REVEALED IF YOU DO NOT CHOOSE TO HAVE IT CONSIDERED AS A BASIS FOR REPAYING THIS OBLIGATION
TRADE REFERENCES
Who financed previous truck or auto purchases? (Names and Addresses):
With whom do you have open accounts for gas, tires, etc.? (Names and Addresses):
Bank With: (Name and Address):
Phone:
Account Number:
Person to Contact:
LIST BELOW LOAN OR INSTALLMENT OBLIGATIONS NOW OWING (IF NONE STATE "NONE")
Owed To:
Address:
Balance Unpaid:
Amount Monthly Payment:
Owed To:
Address:
Balance Unpaid:
Amount Monthly Payment:
Owed To:
Address:
Balance Unpaid:
Amount Monthly Payment:
Owed To:
Address:
Balance Unpaid:
Amount Monthly Payment:
Owed To:
Address:
Balance Unpaid:
Amount Monthly Payment:
Total of all contracted monthly installments on above:
Taken Bankruptcy?: YesNo
Date:
Type:
Good Repossessed?: YesNo
Voluntary Date:
By Whom:
Describe Circumstances:
REAL ESTATE
Description:
Location:
Title in the name of:
Present Value:
Mortgages:
Mortgages Held By:
Description:
Location:
Title in the name of:
Present Value:
Mortgages:
Mortgages Held By:
INFORMATION ON AUTOMOTIVE INSURANCE IF NOT PROVIDED FOR THROUGH COMPANY FINANCE PLAN
Type of Coverage:
Fire and Theft:
Collision:
Public Liability & Property Damage:
Name of Insurance Co.:
Policy No.:
Amount:
Average Monthly Miles Driven:
Products Hauled:
Years of Experience as Owner:
Years of Experience as Driver:
Gross Revenue Last Fiscal Year:
Under $1.0 Million:
Over $1.0 Million:
Ownership Experience
Previously Owned Navistar:
Other:
Trailers:
Currently Owned Navistar:
Other:
Trailers:
Revenue Based ON:
$ Per Mile:
% of revenue:
Per Load:
Other (Describe):
Contract/Lease With:
Phone Number:
Person to Contact:
type of Contract/Lease:
Contractor Agreement
Trip Lease
Date of Contract:
Contact Expiration Date:
Previous Contract/Lease With:
Phone Number:
Person to Contact:
Reason for Change:
COMPLETE THIS SECTION IF THE TURK IS TO BE OPERATED BY HIRED DRIVER
Driver Name:
Social Security Number:
Driver License Number:
State:
Years Experience:
Address:
Use this space for additional comments.
Site Hosted By...TruckPaper.com ®
© Copyright by Sandhills Publishing Company 2008. All rights reserved. Reproduction of material appearing on this Web site is strictly prohibited without written permission. North Central Truck Paper, Great Lakes Truck Paper, South Central Truck Paper, Western Truck Paper, South Eastern Truck Paper, Mid Atlantic Truck Paper, Mountain West Truck Paper, and Central Truck Paper are registered trademarks of Sandhills Publishing Company.