APPLICATION TO LEASE TRUCK  APPLICATION FOR STOCK #    VIN #    DOWN PAYMENT (DEPOSIT)    TERM    MONTHLY PAYMENT   APPLICANT  APPLICANTS NAME    SOCIAL SECURITY #    ADDRESS    CITY    STATE    ZIP    COUNTY    HOW LONG AT LOCATION   Own           Rent          E-MAIL ADDRESS    CDL/ST    DATE OF BIRTH    PHONE    CELL   Corp.           Prop.           Prshp.           Non-Profit          HOW LONG?    IF CORP, TAX I.D. #   CO-APPLICANT  CO-APPLICANTS NAME (GUARANTOR)    SOCIAL SECURITY #    ADDRESS    CITY    STATE    ZIP    COUNTY    HOW LONG AT LOCATION   Own           Rent          E-MAIL ADDRESS    CDL/ST    DATE OF BIRTH    PHONE    CELL   Corp.           Prop.           Prshp.           Non-Profit          HOW LONG?    IF CORP, TAX I.D. #   BANK INFORMATION  FINANCE REFERENCES  LENDER    PHONE #    ACCOUNT #    AMOUNT FINANCED    BALANCE    LENDER    PHONE #    ACCOUNT #    AMOUNT FINANCED    BALANCE    LIST ALL TRUCK CREDIT  LENDER    PHONE #    ACCOUNT #    AMOUNT FINANCED    BALANCE    LENDER    PHONE #    ACCOUNT #    AMOUNT FINANCED    BALANCE    LENDER    PHONE #    ACCOUNT #    AMOUNT FINANCED    BALANCE

REFERENCES  BUSINESS  NAME    CONTACT    PHONE #    NAME    CONTACT    PHONE #    NAME    CONTACT    PHONE #    CLOSEST RELATIVES NOT LIVING WITH YOU  FULL NAME    RELATION    PHONE    ADDRESS    CITY    STATE    ZIP    FULL NAME    RELATION    PHONE    ADDRESS    CITY    STATE    ZIP    PERSONAL REFERENCES  FULL NAME    RELATION    PHONE    ADDRESS    CITY    STATE    ZIP    FULL NAME    RELATION    PHONE    ADDRESS    CITY    STATE    ZIP    FULL NAME    RELATION    PHONE    ADDRESS    CITY    STATE    ZIP    FULL NAME    RELATION    PHONE    ADDRESS    CITY    STATE    ZIP

HAULING HISTORY (3 Years)  WHO WILL YOU HAUL FOR?    CONTACT    PHONE #    WHO DO YOU PRESENTLY HAUL FOR?    HOW LONG?    CONTACT    PHONE    WHO DID YOU HAUL FOR IN THE PAST?    HOW LONG?    CONTACT    PHONE    WHO DID YOU HAUL FOR IN THE PAST?    HOW LONG?    CONTACT    PHONE    WHO DID YOU HAUL FOR IN THE PAST?    HOW LONG?    CONTACT    PHONE    VEHICLE OWNERSHIP AND USAGE Is this a:           Replacement           Additional           New truck    HOW MANY TRUCKS NOW OWNED    WHAT WILL YOU HAUL    DRIVER OF TRUCK IF NOT PURCHASER    CDL/ST    WHERE WILL TRUCK BE PARKED    INSURANCE PROVIDER    CONTACT    PHONE

ASSETS AND LIABILITIES  ASSETS (YOU OWN)  VALUE  LIABILITIES (YOU OWE)  $ BAL  CASH ON HAND & IN BANKS                                        TRUCKS/TRAILERS OWNED                                                        REAL ESTATE OWNED                                        OTHER ASSETS (CARS, ETC.)    OTHER DEBTS                                   AUTHORIZATION The information given above is true and complete. Lender may receive from and disclose to other persons, including credit reporting agencies, information about applicant's accounts and credit experience and applicant authorizes any person to release to Lender credit experience and account information on applicant. This shall be a continuing authorization for all present and future disclosures of account information and credit experience on applicant made by Lender or any person requested to release such information to lender.  DATE    SIGNATURE / TITLE

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