1b- Fresh Start Lead Cap - Credit Application

GET FINANCING NOW

Note: Your privacy is very important to us. To better serve you, the form information you enter is recorded in real time.

Amount to Finance* $

When you need it?*

Type of Truck or Equipment?*

Year of Truck or Equipment?*

Annual Income?* $

This is your estimated annual personal income

Down Payment?* $

How much cash do you plan on putting down?

Person 1 Information

Person 1 Name*

First Name

Last Name

Person 1 Title

Position in your Company

Person 1 Email*

Enter a valid email address

Person 1 Cell Phone*

Enter as: 123-234-3456

Person 1 Date of Birth*

MM/DD/YYYY

How's Your Credit?*

Choose 1 option

Person 1 Information - cont

Person 1 SSN*

Confirm *

Enter in this format: xxx-xx-xxxx

Person 1 Address*

Address Line 1

City

State

ZIP Code

Homeowner?*

Yes No

Are you a homeowner?

Corporation Type*

S-Corp C-Corp LLC Sole Proprietor DBA

Select one

Person 1 Name

First Name

Last Name

Person 1 Cell Phone

Enter as: 123-234-3456

Business Source

Marketing

Would You Like To Fill Out A Credit Application?

Yes

Company Information - cont

Company Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Federal Tax ID*

Confirm *

Enter in this format: XX-XXXXXXX for FEIN OR XXX-XX-XXXX for SSN

% Owned

Percentage of Business Owned

Fleet Size

Number of Trucks in Fleet

Do You Require A Second Applicant?

Person 2*

Yes No

Person 2 Name

First Name

Last Name

Person 2 Title

Position in your Company.

Person 2 Email

Enter a valid email address

Person 2 Information - cont

Person 2 Address

Address Line 1

Address Line 2

City

State

ZIP Code

Person 2 SSN

Confirm *

Enter in this format: xxx-xx-xxxx

Person 1

Agreement*

Yes, I agree to the Terms and Conditions of this application. The undersigned certifies that the above information given for credit purposes is true and correct and authorizes the firm to whom this application is made, or an entity of the firm chooses to submit this application to, any credit bureau or investigative agency to investigate the references, statements, or other data listed or accompanying this application. The undersigned authorizes all parties contacted to release credit and finance information requested as part of said investigations. PLEASE NOTE: NO advance payment or money will be requested or collected prior to a credit approval. However, once payments are collected, if you choose to not use the firm, a refund of this money will be at the firm’s discretion. By signing below, you clearly understand these terms. EQUAL CREDIT OPPORTUNITY ACT: If your application for business credit is denied, you have a right to a written statement of the specific reasons for the denial. To obtain the statement, please contact Commercial Fleet Financing, Inc. within 60 days from the date you are notified of our decision. Our mailing address is: Commercial Fleet Financing, Inc. 1445 MacArthur Dr. Suite 216 Carrollton, TX 75007. Our telephone number is 972-247-8447. We will send you a written statement of reasons for denial within 30 days of receiving your request for the statement. The federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, gender, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant's income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with this law concerning this creditor is the Consumer Financial Protection Bureau, 1700 G Street NW, Washington DC 20006.

Name Person 1*

First Name

Last Name

Title Person 1*

Position in your Company.

Today's Date - Person 1*

MM/DD/YYYY

Person 2

Name Person 2

First Name

Last Name

Title Person 2

Position in your Company.

Today's Date - Person 2

MM/DD/YYYY

First Click Landing Page

Campaign Source

This hidden field has been added by Attribution to CRM Plugin to store Campaign Source in this Form's submission table

Campaign Medium

This hidden field has been added by Attribution to CRM Plugin to store Campaign Medium in this Form's submission table

First Click Campaign

First Click Channel

Campaign Content

This hidden field has been added by Attribution to CRM Plugin to store Campaign Content in this Form's submission table

Campaign Name

This hidden field has been added by Attribution to CRM Plugin to store Campaign Name in this Form's submission table

First Click Medium

First Click Source

GCLID (Google Click Identifier)

This hidden field has been added by Attribution to CRM Plugin to store GCLID (Google Click Identifier) in this Form's submission table

First Click Term

First Click Source