7644 Kings Pointe Rd Toledo, OH 43617 419-214-4502 info@holtfinance.com

Tarp Systems Financing Application

Tarp Systems 

Personal Information

Name*

Address

City, State, & Zip

Social Security Number*

--

Date of Birth

 /  / 

Contact Number

- -

Home Owner?

YesNo

Have you had any repossessions in the past 8 years?

YesNo

Company Information

Company Name

Date Formed

 /  / 

Annual Revenue

Number of Employees

Number of Trucks Owned

Number of Trailers Owned

Does your trailer have a lien?

YesNo

If yes, how much?

Trucking Industry Experience

Hauling Reference Company Name

Hauling Reference Contact Number

- -

Contact Name:

Equipment-Vendor Information

What do you Haul?

Have you picked out the equipment you want to finance?

YesNo

Equipment Description:

Cost of Equipment

Salesperson Name:

Electronic Signature *

By typing your full name below, each undersigned individual(s), who is either a principal of the credit applicant listed below or a personal guarantor of its obligations, provides written instruction to First Rate Transportation Finance, LLC, or its designee (and any assignee or potential assignee thereof) authorizing review of his or her personal credit file from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering the application of the credit applicant and subsequently for the purpose of update, renewal, or extension of such credit, and for reviewing or collecting the result account. A photo static or facsimile copy of this authorization shall be as valid as the original.

*Must be a resident of Ohio, Michigan, Indiana, Kentucky, West Virginia or Western Pennsylvania

Holt Truck Finance

7644 Kings Pointe Rd Toledo, OH 43617
Phone: 419-214-4502
Fax: 419-720-3980
Email: info@holtfinance.com