Online Credit App - WMI Trucks

Statement of Consent

I certify that the information provided by me is correct. I also understand that you will be checking with credit reporting agencies. I authorize an investigation of my credit and employment history and the release of information about my credit experience.

Please initial below to indicate that you have received a copy of our Privacy Notice and agree to all of the above.

YOUR CREDIT APPLICATION IS GOING THROUGH A SECURE WEBSITE AND YOUR IDENTITY IS SAFE

Initial Here(Required)

Vehicle Information

Type(Required)

Condition

Year

Make

Model

Down Payment ($)

Your Contact Information

Name As It Appears on Driver's License

Name(Required)

First Middle Last

Driver's License

Work Phone

Residence Phone

Social Security Number

Male / Female

Date of Birth

Marital Status

Business Name

Guarantor

Business Type

Fed Tax ID

Annual Revenue

Years in Business

Years Driving Experience

Number of currently owned trucks and trailers

Number of trucks and trailers owned in the past

First time buyer?

Haul Sources

Name(Required)

Phone(Required)

Contact

How Long

Name

Phone

Contact

How Long

Name

Phone

Contact

How Long

Name of Equipment Lenders

Name

Phone

Contact

Name

Phone

Contact

Name

Phone

Contact

Physical Address Information

Physical Address

Street Address City State / Province / Region ZIP / Postal Code Country

Housing Information

Do you Rent or Own your home, or other?

Previous Residence (If less than 5 years at Current Residence...)

Address

Street Address City State / Province / Region ZIP / Postal Code Country

How long at Previous Residence

Year

Months

Additional Comments

Please include any information that you feel may help us process your application.

How much money can you or would you like to put down?

Do you have any Repossessions?

Do you have any Tax Liens?

What Rate are you looking for?

Any Arrears in child support?

Have you ever filed for Bankruptcy?

Any charge-off or Foreclosure?