Hoefling Truck & Tractor

For your convenience you may fill out the application below, print, and bring in.

[FrontPage Save Results Component]

GENERAL APPLICANT INFORMATION

Please tell us what you expect to purchase:
Tax ID # or SSN:	Driver's License	Issuing State: DL#	Date Of Birth:
First Name:	Middle Name:		Last Name:
Business Name:
Street Address:			Email:
City:	State:		Zip:
Yrs At Address:	Type of Residence: Own Rent Lease Board Other

*Please Complete The Mailing Address If It Is Different Than The Physical Address*
Mailing Address:
City:	State:		Zip:
Home Area/Phone:		Business Area/Phone:

*If At Address Less Than 3 Years, Please Indicate Your Previous Address*
Street Address:		Yrs At Address:
City:	State:		Zip:

CURRENT EMPLOYER INFORMATION

Employer Name:		Work Area/Phone:
Employer Address:
City:	State:		Zip:
Position:	Yrs on Job:		Gross Mo. Salary:

PREVIOUS EMPLOYER (If At Current Employer Less Than 2 Years)

Employer Name:		Work Area/Phone:
Employer Address:
City:	State:		Zip:
Position:	Yrs on Job:		Gross Mo. Salary:

BUSINESS OR AGRICULTURAL INFORMATION

If you are self employed, list your business type:

Proprietorship

Partnership

Corporation

Business Activity:	Farming	Plumbing/Sewer	Excavating	Sand/Gravel
	Rental	Construction	Golf Course	Landscaping/Mowing
No. of yrs farming:		Part Time	Full Time	Total No. of Acres:

Type of Livestock/Crops

Est Annual Farm Income $

Market Date

OTHER INCOME

(Alimony, Child Support, Or Separate Maintenance Payments Need Not Be Disclosed Unless Relied Upon For Creditworthiness)

Source of Other Income

Gross Monthly Amount $

REFERENCES

Nearest Relative Not Living With You			Landlord/Mortgage Information
Name			Name
Address			Address
Address			Address
City			City
State, Zip			State, Zip
Telephone			Telephone
Relationship			Contact
			Account No.

Bank Information			Other Lender
Name			Name
Address			Address
Address			Address
City			City
State, Zip			State, Zip
Telephone			Telephone
Contact			Contact
Account No.			Account No.

PLEASE INDICATE WHICH OF THE BELOW ITEMS MAY APPLY TO YOU

Financed Through Us Before		Filed Bankruptcy
Had A Repossession		Been Subject To a Tax Lien
Been Sued		Had A Foreclosure

I HEREBY CERTIFY THAT THESE STATEMENTS ARE CORRECT TO THE BEST OF MY KNOWLEDGE AND ARE MADE FOR THE PURPOSE OF OBTAINING FINANCING FROM ONE OF OUR CREDIT PROVIDERS.

I AUTHORIZE YOU TO OBTAIN ANY INFORMATION INCLUDING BUT NOT LIMITED TO CREDIT REPORTS WHICH YOU MAY REQUIRE CONCERNING THIS APPLICATION AND I AGREE THAT THIS APPLICATION SHALL REMAIN YOUR PROPERTY, WHETHER THE FINANCING IS GRANTED OR NOT. I ACKNOWLEDGE RECEIPT OF A COPY OF THIS APPLICATION SHEET.

Signature: ____________________________________________ Date: __________________

Print Name: ___________________________________________