Finance Application | Buckeye Western Star & Yard Trucks of Ohio

Borrower Information

Fields with an asterisk (*) are required

First Name*

Middle Name

Last Name*

Home Phone

Mobile Phone*

Email

Social Security Number*

Encrypted with 128-bit bank grade encryption

Company Name

Tax ID/EIN

Company Structure

Company Started Date

Ownership Experience*

Birthdate*

Co-Borrower Information

First Name

Last Name

Birthdate

Social Security Number

Encrypted with 128-bit bank grade encryption

Street Address

Address 2

City

State

Zip

Mobile Phone

Employer Name

Time at Employer

Income (Annual Gross)

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Residence Information

Fields with an astrix (*) are required

Street Address*

Address 2

City*

State*

Zip*

County*

(Not Country)

Time at residence*

Do you own or rent your home?

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Current Employment Information

Fields with an astrix (*) are required

Employment Type*

Occupation

Time at Employer

Salary (Annual Gross)

Employer Name

Employer Phone

Employer Address

Employer Address 2

Employer City

Employer State

Employer Zip

Current Position

Years as Owner Operator

Years in Trucking

Previous Employer Information

Employer Name

Contact Name

Contact Phone

Employer Location

Employment Length

Employer Name

Contact Name

Contact Phone

Employer Location

Employment Length

Future Employer Information

Same as Current

Employer Name

Contact Name

Contact Phone

Employer Location

Commercial DL #

Monthly Revenue

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Bank/Credit References

Creditor / Bank Name

Contact Name

Phone

Location

Account Type

Account Number

Creditor / Bank Name

Contact Name

Phone

Location

Account Type

Account Number

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Existing Equipment

Equipment Type

Owned

Financed

Leased

Equipment Type

Owned

Financed

Leased

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References

Name

Phone

Location

Name

Phone

Location

Name

Phone

Location

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Statement of Consent

Fields with an astrix (*) are required

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 signature*

Please provide your sales representative's name so we can route your application properly.

Sales Representative (optional)

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Buckeye Western Star & Yard Trucks of Ohio

Secure Financing Application

Borrower Information

Borrower Information

Co-Borrower Information

Co-Borrower Information

Residence Information

Residence Information

Previous Residence Information

Employment Information

Current Employment Information

Previous Employer Information

Future Employer Information

Credit/Bank References

Bank/Credit References

Existing Equipment

Existing Equipment

References

References

Consent

Statement of Consent