H.E.C. LEASING, LLC :: Nashville, TN Reliable Trucks, Trailers and Other Equipment

Credit Application

Company Information

Company Name / DBA:

Address:

City: State: Zip: County:

Date established: Years of Current Ownership:

Contact Person: Phone: Fax:

Structure of Ownership (Corp.,Part.,Prop.)

Number of trucks owned or leased:

Number of Employees: FEd tax id:

Email adress:

Owner-Operator Information

Name: do you own any other trucks: yes no

Description of truck:

Home Address:

City: State: Zip: County:

own/rent: S.S.#:

Phone: Cell: Email:

Have you filed bankruptcy: yes no When:

Company leased to: Contact:

Length of lease: miles per week:

Company address:

City: State: Zip: County:

Office Phone: Weekly Income:

Bank Reference

Bank Name: Name on Account:

contact: Bank Phone:

Acct Type: Date Opened: Acct. #:

Trade Reference

Name: Name on Account:

contact: Bank Phone:

Name: Name on Account:

contact: Bank Phone:

Authorization to Release Information

By checking the 'I Agree' box below, the undersigned individual(s) who is either a principal of the credit applicant or a personal guarantor of its obligations, provides written instruction and authority to HEC Leasing, LLC or its Designee as well as a and in addition to any assignee or potential assignee thereof authorizing review of his/her personal credit profile from a national credit bureau. Such authorization shall extend to obtaining a credit profile in considering this application and subsequently for the purpose of update, renewal or extension of credit or additional credit and for reviewing or collecting the resulting account. A photocopy or faxed copy of this authorization shall be valid as the original. The Federal Equal Credit prohibits creditors from discriminating against credit applications on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract), because all or a part of the applicant's income derives from any public assistance program, or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal agency that administers compliance with this law concerning this credit is: Federal Trade Commission, Equal Credit Opportunity, Washing D.C. 20580.

I AGREE I DO NOT AGREE