Dear Customer, Please complete this application in its entirety to expedite the processing of your application. We look forward to doing business with you. If you have any questions, please call the credit department at 309‐445‐8100.

Application Procedures:

Online Credit Application

Full Name*
Title*
Soc. Sec. No.*
Business Name*
Date of Birth*
Month
Day
Year
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Fax*
Email*
Date business established*
Month
Day
Year
Federal ID #*
Type of Organization*
- Corporation
- Patnership
- Individual
Type of Business*
P.O. Required*
- Yes
- No

Principles, Officers or Partner*

Who is authorized to purchase*

Approximate monthly purchases anticipated $*
We own and/or operate
Trucks*
Tractors*
Trailers*
Lease With*
Address*
Street Address Address Line 2 City State ZIP Code
Bank Accounts
Name of the Bank
Address*
Street Address Address Line 2 City State ZIP Code
Type of Account(s) and Account Number(s)
Savings*
Checking*
Loan*
Credit References (MUST HAVE COMPLETE NAMES AND ADDRESSES)
Refrence-1
Name
Email
Address
Street Address Address Line 2 City State ZIP Code
Refrence-2
Name
Email
Address
Street Address Address Line 2 City State ZIP Code
Refrence-3
Name
Email
Address
Street Address Address Line 2 City State ZIP Code
Refrence-4
Name
Email
Address
Street Address Address Line 2 City State ZIP Code
In consideration for the granting of credit, we (I) submit the above information which you may rely on as being accurate. We (I) further authorize you to investigate any and all statements contained herein and further authorize any of our (my) creditors to release information to you regarding our (my) financial status. A copy of this agreement is also as binding as the original. In the event that the necessity should arise for Central Truck Leasing, LLC to place any claim in litigation, purchaser agrees that said claim would be under the jurisdiction of the Circuit Court of McLean County, State of Illinois, and further agrees that they are liable for and agree to pay the unpaid balance, together with court costs incurred, plus collection costs and/or reasonable attorney fees, which shall not be less than one‐third of the balance due, regardless of whether account is litigated. APPLICANTS SIGNATURE ATTESTS FINANCIAL RESPONSIBILITY, ABILITY AND WILLINGNESS TO PAY OUR INVOICES IN ACCORDANCE WITH THE FOLLOWING TERMS: CREDIT TERMS AND POLICIES 1. All accounts are considered past due if not paid in full by the 10th day of the next month after purchase, and are subject to a finance charge computed by a single periodic rate of 1.5% per month, which is an annual percentage rate of 18%. 2. Also accounts not paid in full by the 30th day following purchase will be held on a cash only basis. Accounts will remain on cash only basis until the entire past‐due amount is paid in full, including all service charges. 3. Accounts 45 days past due may be turned over to our attorney for collection. 4. A statement of the account will be mailed monthly to every customer that has an open balance. 5. All accounts will have an established credit limit and in order to exceed that credit limit special arrangements will have to be made. 6. Tax Exemption: For tax exempt customer, State Tax Law requires that you have on file with us your RUT‐7 or resale number and a copy of that authority. You will be charged tax until all of this proper information and copies are on file.
- I Agree
MUST BE SIGNED BY OWNER OR DULY AUTHORIZED OFFICER OF THE CORPORATION
Signature*
Printed Name*
Title*
Date*
MM
DD
YYYY
Witness*
Date*
Month
Day
Year
If Corporation: Individually guaranteed by:
Signature
Printed Name
Title
Date
MM
Day
Year
Witness
Date
Month
Day
Year
Signature
Printed Name
Address
Date
Month
Day
Year
Date*
Month
Day
Year

To*

I, the undersigned, applying for credit with Central Truck Leasing, LLC do hereby authorize the above named creditor, bank or lending institution to release any and all information to Central Truck Leasing, LLC, as they may deem necessary for the purpose of extending credit.

Signature*
Printed Name*
Business Name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Online Credit Application

Online Credit Application

We own and/or operate

Bank Accounts

Type of Account(s) and Account Number(s)

Credit References (MUST HAVE COMPLETE NAMES AND ADDRESSES)

Refrence-1

Refrence-2

Refrence-3

Refrence-4

MUST BE SIGNED BY OWNER OR DULY AUTHORIZED OFFICER OF THE CORPORATION

If Corporation: Individually guaranteed by:

CIT TRUCKS

LOCATIONS

RESOURCES

NEWSLETTER SIGN-UP