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Credit Application

Contact Information

(Please Complete all Fields in the Section)

Company Name:

Contact Name:

Phone Number:

Email Address:

Buyer's Address:

Buyer's/Co-Buyers' Information

(Please Complete all Fields in the Section)

Buyer's Name:

Phone Number:

Social Security:

Email Address:

Co-Buyer's Address:

Co-Buyer's Name:

Phone Number:

Fax Number:

Email Address:

Co-Buyer's Address:

Qualifying Questions

(Please Complete all Fields in the Section)

How long at Present Address:

Years:

Months:

Rent or Own?:

Mortgage Company or Landlord:

Phone Number:

How many years has your company been active?

How long have you had your CDL?

Registering in FL? Yes or No?

Will this be your

How many Employees

If Required, could any of your trucks be pledge for additional collateral?

Yes or No?

Copy of Applicant's Identification

Copy of Co-Applicant's Identification

The Undersigned certifies that the above information given for credit purposes is true and correct. The undersigned also authorizes Victor Logistics and/or it associates any access to credit bureau or other investigation agency to investigate the references, Statements or Data Listed in or accompanying this application as in necessary. The undersigned authorizes all parties contracted to release credit and financial information as part of said investigation.