Commercial Credit Application

DJ LEASING LLC, dba STERNBERG AUTOMOTIVE GROUP

Be assured that the information you submit is kept secure and confidential.
*In order to process a quick response please input data in all fields that apply

Application Date

Business or Corporate Name*:

Business Address*:

Business City & State*:

Business Zip*:

Business Email*:

Business Phone*:

Business Fax:

Billing Address:

Billing City & State:

Billing Zip:

Banking Information

Name of Bank:

Address:

City & State:

Zip:

Bank Phone:

Bank Account Number:

Supplier References

Supplier Reference #1

First Name

Last Name

Address:

City & State:

Zip:

Phone:

Account Number:

Supplier Reference #2

First Name

Last Name

Address:

City & State:

Zip:

Phone:

Account Number:

Supplier Reference #3

First Name

Last Name

Address:

City & State:

Zip:

Phone:

Account Number:

Have You Done Business with Sternberg Locations?
YesNo

Has Applicant or Any of Its Owners, Principals, Partners, Officers or Directors Ever Filed a Voluntary Petition in Bankruptcy or Been Adjudged Bankrupt?
YesNo

Is Applicant or Any of Its Owners, Principals, Partners, Officers or Directors a Guarantor or Endorser of Debts or Notes Owed by Other?
YesNo

Are There Any Past Due Taxes Owed by Applicant?
YesNo

Owners, Officers, Members

Owners (if Applicant is a Sole Proprietorship or Partnership), Officers (if a Corporation), Members (if LLC)

Owner, Officer or Member #1

First Name:

Last Name:

Social Security Number:

Phone:

Address:

City & State:

Zip:

Owner, Officer or Member #2

First Name:

Last Name:

Social Security Number:

Phone:

Address:

City & State:

Zip:

Owner, Officer or Member #3

First Name:

Last Name:

Social Security Number:

Phone:

Address:

City & State:

Zip:

Certification and Agreement

By clicking submit, the undersigned warrants the above Application for Commercial Credit has been carefully read and the Applicant understands the same. Please read carefully.

Fair Credit Reporting Act Disclosure: By submitting this application, I understand you will be checking with credit reporting agencies and that the information provided by me is complete and accurate to the best of my knowledge. I also understand I may request in writing within a reasonable time a full disclosure report. Though this application will be forwarded to available financial institutions, I understand this does not obligate me in any way to use their financing source(s). Fair Credit Reporting Act Disclosure: By submitting this application, I understand you will be checking with credit reporting agencies and that the information provided by me is complete and accurate to the best of my knowledge. I also understand I may request in writing within a reasonable time a full disclosure report. Though this application will be forwarded to available financial institutions, I understand this does not obligate me in any way to use their financing source(s). Fair Credit Reporting Act Disclosure: By submitting this application, I understand you will be checking with credit reporting agencies and that the information provided by me is complete and accurate to the best of my knowledge. I also understand I may request in writing within a reasonable time a full disclosure report. Though this application will be forwarded to available financial institutions, I understand this does not obligate me in any way to use their financing source(s). Fair Credit Reporting Act Disclosure: By submitting this application, I understand you will be checking with credit reporting agencies and that the information provided by me is complete and accurate to the best of my knowledge. I also understand I may request in writing within a reasonable time a full disclosure report. Though this application will be forwarded to available financial institutions, I understand this does not obligate me in any way to use their financing source(s). Fair Credit Reporting Act Disclosure: By submitting this application, I understand you will be checking with credit reporting agencies and that the information provided by me is complete and accurate to the best of my knowledge. I also understand I may request in writing within a reasonable time a full disclosure report. Though this application will be forwarded to available financial institutions, I understand this does not obligate me in any way to use their financing source(s). Fair Credit Reporting Act Disclosure: By submitting this application, I understand you will be checking with credit reporting agencies and that the information provided by me is complete and accurate to the best of my knowledge. I also understand I may request in writing within a reasonable time a full disclosure report. Though this application will be forwarded to available financial institutions, I understand this does not obligate me in any way to use their financing source(s). Fair Credit Reporting Act Disclosure: By submitting this application, I understand you will be checking with credit reporting agencies and that the information provided by me is complete and accurate to the best of my knowledge. I also understand I may request in writing within a reasonable time a full disclosure report. Though this application will be forwarded to available financial institutions, I understand this does not obligate me in any way to use their financing source(s).

Name of Business Applicant*:

Title of Business Applicant:

Please Sign Your Name Below:

Locally Owned and Operated by Sternberg Automotive Group since 1967

Sternberg Automotive Group provides services for just about every facet of the transportation market. Cars, trucks, leasing, rental, parts, vehicle repair, equipment, collision repair – you name it, Sternberg Automotive Group has it!

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