Commercial Credit Application

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

Preferred Salesman:

Business Information

Business Name:


ProprietorCorporationPartnershipLLC

Business Address:

City & State (business):

Zip (business):

Contact Person:

Contact Phone:

Billing Address:

City & State (Billing):

Zip (Billing):

Years in Business:

Federal Tax ID Number:

Dun & Bradstreet:

Type of Business:

Primary use of Truck:

Do you have your own authority?
YesNo

US DOT Number:

Are you Tax Exempt?

If so, Tax Exempt Number:

Is PO Required?
YesNo

Type of Truck:
Start UpReplacementAdditional Equipment

Current Fleet Size:

Years of Experience as Driver:

Years of Experience as Owner Operator:

Applicant to Drive?
YesNo

If no, Driver's Name:

Driver's License Number:

Expiration Date:

Owner Operation Contract with:

Name of Contract:

Years with Company:

Phone Number for Contract:

Yearly Income:

Business Officer #1

Name

Title

Business Officer #2

Name

Title

Business Officer #3

Name

Title

Business Officer #4

Name

Title

Trade References

Trade Reference #1

First Name

Last Name

Address:

City & State:

Zip:

Phone:

Trade Reference #2

First Name

Last Name

Address:

City & State:

Zip:

Phone:

Personal Information

*First Name:

*Last Name:

Phone:

*Email:

Date of Birth::

Social Security Number:

Years at current address:

Months at current address:

Please Check one of the following:
Own/Buying homeLeasing/RentingLiving with Relative or Friend

Name of Landlord or Mortgage Holder:

Phone Number of Landlord or Mortgage Holder:

Reference #1 (relative not living with you)

Name:

Relationship:

Phone:

Reference #2 (relative not living with you)

Name:

Relationship:

Phone:

Co-Applicant Personal Information

First Name:

Last Name:

Date of Birth::

Social Security Number:

Current Employer:

Employer's Phone:

Annual Income:

Driver's License Number:

State:

Years of Driving Experience as Driver:

Years of Driving Experience as Owner Operator:

Banking Information

Name of Bank:

Bank Phone:

Accounts:
Checking and SavingsChecking OnlySavings OnlyOtherNone

Do you have any current auto loans?
YesNo

Outstanding Personal Loan #1

Name of Bank:

Amount Borrowed:

Monthly Payment:

OpenedClosed

Outstanding Personal Loan #2

Name of Bank:

Amount Borrowed:

Monthly Payment:

OpenedClosed

Have you ever filed for bankruptcy?
YesNo

Type of bankruptcy?
Chapter 7Chapter 13

Has the bankruptcy been discharged?
YesNo

If yes, date of discharge:

By clicking submit, you agree to the Fair Credit Reporting Act Disclosure and Privacy Policy and allow Sternberg, Inc. to check your credit.

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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