DEALER FINANCIAL APPLICATION

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Dealer Information

Company Legal Name:

DBA if Applicable:

Dealer License #

Physical Address:

City:

State:

Zip:

Phone:

Years in Business:

Business Type:

Corporation

Partnership

Sole Proprietorship

LLC

Annual Sales

Number of Employees

Amount Requested:

TIN / FEIN

Current Floor Plans and Amounts

Officer Owner Information

Officer/Owner Name:

Title:

SS#

Ownership %

Home Address:

City:

State:

Zip:

Email:

Cell Phone:

Home Phone:

Partner/Co-Owner Information

Partner/Co-Owner Name:

SS#

Ownership %

Home Address:

City:

State:

Zip:

Email:

Cell Phone:

Home Phone:

References

Auction Reference:

Phone:

Business Reference:

Phone:

Signatures

Owner Signature:

Date

Co-Owner Signature:

Date

Typing your name here constitutes your signature. and will authorize us to processes your application.

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