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