Business Loan Application

Required fields are marked with an asterisk *

Montana Commerical Credit, Inc.

Lessee/Applicant

Legal Business Name/Lessee*

Federal Tax ID

Tax Filing Type

Time in Business

Business Address

City

County

State

ZIP

Business Phone*

Business Fax

Contact Name

Email Address

Physical Address/Location of Equipment (when not at a jobsite)

# Trucks

# Trailers

MC/USDOT #

Principals (Owner, Shareholders, or Partners)

1. Name

Title

% Ownership

Date of Birth

Social Security #

Home Address

City

State

ZIP

Home Phone

Cell Phone

Haul Source

Haul Source Name

Phone Number

Contact Name

Equipment Financing

1. Name/Branch*

City

State

Customer Since

Loan Account #

Highest Credit

Phone*

Contact

Purpose

Equipment to Purchase*

Dealer Name

Cost*

Signature

*The information provided above is true and complete. Montana Commerical Credit, Inc. and/or its assigns is authorized to check my credit and employment history. I authorize all past and present creditors, and credit reporting agencies, to release any and all necessary credit information to Montana Commerical Credit, Inc. and/or its assigns. This shall be a continuing authorization for all present and future disclosures of account information on the Applicant.