Apply for Transportation (Truck & Trailer) Financing

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Part 1: Business Information
Your Business's Legal Name*

If there is no business name, write your personal name.
Federal Tax ID Number
Type of Business*
- Proprietorship
- Partnership
- Corporation
- LLC
Business Phone Number*
Fax Number
Business Address*
Street Address Address Line 2 City State ZIP Code
Is this a start-up, or an established business?*
- Start-up
- Established Business
Date Established*
MM slash DD slash YYYY
How many owners does your organization have?*
- 1
- 2
- 3
We will ask for the information for each owner/co-applicant.
Part 2: Ownership Information - Owner 1
Applicant Name*
First Last
Your % of Ownership?*
Annual Income*
SSN*
Date of Birth*
MM slash DD slash YYYY
Mobile Phone*
Business Phone*
Email*
Do we have permission to email you at this address?*
- Yes
- No
Home Address*
Street Address Address Line 2 City State ZIP Code
Are you a home owner?*
- Yes
- No
Amount of Rent or Mortgage Each Month*
Have you been at this address for less than 5 years?*
- Yes
- No
Former Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If you've lived at your current address for less than 6 years, provide your prior address.
Have you ever taken bankruptcy?*
- Yes
- No
Please provide details on when, and the circumstances of your bankruptcy.
Have you ever had a repossession?*
- Yes
- No
Please provide details on when, and the circumstances of your reposession.
Are you a defendant in a legal action?*
- Yes
- No
Please provide details on when, and the circumstances of the court case.
Part 2: Ownership Information - Owner 2
Applicant Name
First Last
Your % of Ownership?
Annual Income
SSN
Mobile Phone
Business Phone
Email
Do we have permission to email you at this address?
- Yes
- No
Date of Birth
MM slash DD slash YYYY
Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are you a home owner?
- Yes
- No
Amount of Rent or Mortgage Each Month
Have you been at this address for less than 5 years?
- Yes
- No
Former Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If you've lived at your current address for less than 6 years, provide your prior address.
Have you ever taken bankruptcy?
- Yes
- No
Please provide details on when, and the circumstances of your bankruptcy.
Have you ever had a reposession?
- Yes
- No
Please provide details on when, and the circumstances of your reposession.
Are you a defendant in a legal action?
- Yes
- No
Please provide details on when, and the circumstances of the court case.
Part 2: Ownership Information - Owner 3
Applicant Name
First Last
Your % of Ownership?
Annual Income
SSN
Mobile Phone
Business Phone
Email
Do we have permission to email you at this address?
- Yes
- No
Date of Birth
MM slash DD slash YYYY
Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are you a home owner?
- Yes
- No
Amount of Rent or Mortgage Each Month
Have you been at this address for less than 5 years?
- Yes
- No
Former Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If you've lived at your current address for less than 6 years, provide your prior address.
Have you ever taken bankruptcy?
- Yes
- No
Please provide details on when, and the circumstances of your bankruptcy.
Have you ever had a reposession?
- Yes
- No
Please provide details on when, and the circumstances of your reposession.
Are you a defendant in a legal action?
- Yes
- No
Please provide details on when, and the circumstances of the court case.
Employment
First Time Owner/Operator?*
- Yes
- No
- N/A
Time with a CDL*
Time as an Owner/Operator*
Reason for Your Purchase*
- 1st Truck
- Additional Truck
- Replacement Truck
Will the buyer drive this truck?*
- Yes
- No
Type of Goods Hauled
In what state will the truck be registered?
The truck will be titled in:
- Your Personal Name
- The Business's Name
Current Employer/Haul Reference

Business name.
Current Haul Reference Name
First Last
Current Haul Reference Phone Number
How long have you been with your Current Haul company?
Financial Information
Do you have your own authority?*
- Yes
- No
MC Number, if Applicable
Insurance Company
Insurance Agent Name
First Last
Insurance Agent Phone
Number of Trucks Owned*
Number of Trailers Owned*
Will you be trading this in?
- Yes
- No
Consent to Application Terms*
I agree.
The undersigned acknowledge(s) the statements on this application are true, correct and accurate to the best of my/our knowledge and may be used by Perry Funding LLC, its affiliates, funding sources and lenders to make credit decisions. The undersigned authorize(s) Perry Funding LLC, its affiliates, funding sources and lenders to obtain credit reports from credit bureaus and repositories, and to obtain consumer and business information from banks, credit unions, vendors, lenders, and other credit reporting services, and authorizes, directs and requests any and all of the aforesaid to furnish such information in a timely fashion to Perry Funding LLC, its affiliates, funding sources and lenders. The undersigned acknowledge(s) that this signed application form is strictly for the purpose of obtaining business/commercial credit, that this signed application form is an application for credit only, and that the final terms of any loan, lease, or financing will be based upon the documents themselves. No approval or commitment exists until the applicant/join applicants receive(s) a written approval or commitment from Perry Funding LLC, its affiliates, funding sources or lenders. All of the above referenced credit references and sources are directed by the undersigned to accept a photocopy of my/our signature(s) as if it were the original, by fax or email.
Signature*

Please type your name here to affirm that you are submitting this application for credit consideration. This will serve as your signature for the application.
Phone
This field is for validation purposes and should be left unchanged.

Save and Continue Later

Apply for Transportation (Truck & Trailer) Financing

Are you looking for the PDF version of this form? Click HERE to download it to your computer.

Need to Save and Continue Later?

Part 1: Business Information

Part 2: Ownership Information - Owner 1

Part 2: Ownership Information - Owner 2

Part 2: Ownership Information - Owner 3

Employment

Financial Information