Ford Credit App Form – Fill Out and Use This PDF

Legal Name:

Date of Birth (for Individuals):

DBA:

Proprietorship

Corp.

Sub S

LLC.

Partnership

Other:

Tax Exempt Number:

State-issued Organization # (not tax id #):

State of Organization or state of legal residence for individuals:

SOC SEC # / TAX ID #

Gross Profit (Monthly Income)

Type of Business

Yrs in Business

E-Mail and Website Address

Primary Legal/CEO Address: Street

City

County

State

Zip

Billing Address: Street

City

County

State

Zip

(if different from above)

Fleet Manager Name:

Phone #

E-mail Address

Garage Address: Street

City

County

State

Zip

Phone #

Fax #

Mobile Phone #

Contact Name

Owner/Guarantor: Name

Title

Address

PH#

Social Security / TN #

Date of Birth

Ownership %

Owner/Guarantor: Name

Title

Address

PH#

Social Security / TN #

Date of Birth

Ownership %

Note: Sole Proprietor, Individual Co-Applicant(s) or Individual Guarantor(s) must complete this section

Individual (First Name, Middle Name, Last Name, Suffix):

Social Security Number

Date of Birth

only

Home Phone

Own Home Outright

Living with Relatives

Driver’s License No. & State

(

)

Buying Home

Leasing/Renting

Lived There

Yrs.

Mos.

Individuals

Previous Employer / Business (if less than 2 years)

Address

Phone Number

do not wish to have it considered as a basis for repaying this obligation.

(

)

Monthly Income

Secondary Income *

Source

*Alimony, child support or separate maintenance income need not be revealed if you

for

Mortgage Holder / Landlord (Name & Address)

Mortgage Holder / Landlord Phone

Mortgage Payt / Monthly Rent

Complete

(

)

Name & Address of applicant’s nearest relative not in household

Relationship

Home Phone

(

)

Name & Address of applicant’s non-related personal reference known over one year

Relationship

Home Phone

(

)

Please use additional applications if more space is needed for multiple owner, quarantor or applicant information.

Have you previously done business with Ford Motor Credit Company (check one

Yes No) If yes, Acct #:

List other creditors you do business with:

Bank

City & State

Telephone #

Contact

Account #

Trade

City & State

Telephone #

Contact

Account #

IMPORTANT INFORMATION ABOUT ESTABLISHING A RELATIONSHIP WITH FORD CREDIT

For the purpose of securing credit from Ford Motor Credit Company ("Ford Credit"), each of the parties signing below (the "Undersigned") certifies that the above information is true and complete. The Undersigned authorize Ford Credit to: (i) check their respective credit and employment histories, verify income, and provide and/or obtain information about their credit experience with Ford Credit, and (ii) at any time, sell, transfer, or assign any credit secured from Ford Credit and any or all servicing rights with respect thereto, or grant participations therein or issue securities with respect thereto.

The Undersigned each consent and specifically authorize Ford Credit, as it may deem necessary or desirable, to forward any documentation and information which Ford Credit now has or may hereafter acquire in connection with any transaction between any of the Undersigned and Ford Credit to any potential investor, rating agency, and any other party involved in the sale, transfer, assignment, securitization, or participation transaction involving any credit granted to the Undersigned.

Ford Credit may receive from and disclose to other persons, including credit reporting agencies, financial information about the Undersigned and information about each Undersigned’s account and credit experience and each of the Undersigned authorizes any person to release to Ford Credit financial information about the Undersigned and credit experience and account information on the Undersigned. In addition, each of the Undersigned agrees that Ford Credit may receive from and disclose to any of its affiliates, any and all such information now or hereafter provided by the Undersigned to any of the foregoing entities, including without limitation present and future credit applications, financial statements and organizational documents. This is a continuing authorization for all present and future disclosures of financial information, account information and credit experience on the Undersigned made by Ford Credit, or any person requested to release such information to Ford Credit. The Undersigned each agree that a credit report bearing on such Undersigned’s credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or way of living may be requested in connection with this application and future requests for credit. Upon request from any of the Undersigned, Ford Credit will advise such Undersigned, as applicable, whether a credit report was requested and if such a report was requested, Ford Credit, will inform such Undersigned, as applicable, of the name and address of the credit reporting agency that furnished the report.

The Undersigned each agree that Ford Credit, its affiliates, agents and service providers may monitor and record telephone calls regarding my account to assure the quality of service or for other reasons. Each of the Undersigned also expressly consent and agree to Ford Credit, its affiliates, agents and service providers using written, electronic or verbal means to contact the Undersigned. This consent includes, but is not limited to, contact by manual calling methods, prerecorded or artificial voice messages, text messages, emails and/or automatic telephone dialing systems. The Undersigned each agree that Ford Credit, its affiliates, agents and service providers may do so using any e-mail address or any telephone numbers the Undersigned provide, now or in the future, including a number for a cellular phone or other wireless device, regardless of whether the Undersigned incur charges as a result.

SEE NEXT PAGE OF THIS FORM FOR IMPORTANT INFORMATION FOR CALIFORNIA, MAINE, OHIO, RHODE ISLAND, TENNESSEE, AND VERMONT.

Applicant Signature							Title		Date
I intend to apply for joint credit
				Applicant Initial Here
Co-Applicant Signature							Title		Date
I intend to apply for joint credit
				Co-Applicant Initial Here
Guarantor Signature							Title		Date
**If corporate guarantor, authorized officer must sign and show corporate title. If partnership guarantor, a general partner must sign and show ‘‘Partner’’ as Title.
						If individual guarantor, show ‘‘Individual’’ as Title.
								V. 2.4
FC-7144 (REV. February 17)						Please complete page 2 of this application for required transaction specific detail.

BUSINESS CREDIT APPLICATION - PAGE 2

VEHICLE INFORMATION - (All of the below information is tentative and subject to the terms and conditions of the applicable approval letter. Use additional application for multiple vehicles.)

Qty

N/U

Year

Make / Model

GVW

Serial / VIN #

Total CAP Cost

Residual %

Est. Payment

Installed equipment, body uplifts or add-ons, etc. > $1,000.00:

Total cost of body uplifts / add-ons: $

Qty

N/U

Year

Make / Model

GVW

Serial / VIN #

Total CAP Cost

Residual %

Est. Payment

Installed equipment, body uplifts or add-ons, etc. > $1,000.00:

Total cost of body uplifts / add-ons: $

Trade Detail: QTY:

Year

Make / Model

VIN #

Dealer Allowance

Leinholder

Payoff Amount

California Disclosure

Applicant, if married, may apply for a separate account.

Maine Resident

If your credit application is approved and you finance the purchase of your motor vehicle through Creditor, you will be required to insure the vehicle against loss or damage. Creditor requires collision coverage and comprehensive coverage or fire and theft coverage. In addition, if this application is for a lease, Creditor will also require you to obtain liability insurance.

You have the option to select an agent or broker of your choice, whether or not affiliated with Creditor. Obtaining insurance from a particular agent or broker does not affect credit decisions by Creditor, unless the insurance product selected violates the terms of your contract for the purchase or lease of the motor vehicle.

Ohio Disclosure

The Ohio laws against discrimination require that all creditors make credit equally available to all creditworthy customers and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

Rhode Island Resident

A Credit Report may be requested in connection with this application for credit. Vehicle insurance may be obtained from a person of your choice.

Tennessee Resident

You must maintain insurance during the term of the contract. You must give the Creditor evidence of this insurance. The amount and type of insurance must be acceptable to the Creditor. YOU MAY CHOOSE THE PERSON THROUGH WHOM ANY INSURANCE IS OBTAINED.

Vermont Resident

By signing this credit application, Applicant consents to your obtaining a credit report for the purposes of evaluating this application and to obtain subsequent credit reports, in connection with this transaction, for the purpose of reviewing the account, taking collection action on the account or for any other legitimate purpose associated with the account.

FC-7144 (REV. February 17)