423-337-4660 info@tarasport.com

TarasPort Trailers Credit Application

Information about the Credit Applicant

Legal Business Name (required)

Your Name (required)

Mailing Address

County

Phone (required)

Fax

Email (required)

Equipment Location (if different from above)

Type of Business

Time in business as an owner/operator

Business Type

Fed. Tax ID #

ICC or PUCO #

Sales Tax Exempt?
YesNo


Information about the Company Principals (President, Owners or Partners)

Principal1 Name

Principal1 Title

Principal1 Social Security #

Principal1 Home Address

Principal1Home Phone

 

Principal2 Name

Principal2 Title

Principal2 Social Security #

Principal2 Home Address

Principal2 Home Phone


Hauling References

Company1 Name

Address

Phone

Contact

 

Company2 Name

Address

Phone

Contact

 

Insurance Agent

Address

Phone

Contact


Vendor/Equipment Information

Name

Phone

Contact

Name

Fax

Equipment to be purchased

 

Condition
NewUsed

Term (months)

Advance Payments

Gross Amount

Down Payment/Trade

Total Cost (before tax)

 

(REQUIRED) I hereby authorize the release of any credit reference information for the company and individuals listed above, including credit reports, loan, lease, checking, saving and trade accounts to Accord Financial Group and/or its assigns, and I warrant that the information stated above is true and correct.

Date (MM/DD/YYYY): (REQUIRED)

(Application is not complete until you click the Submit button.)