When embarking on the journey of acquiring a Peterbilt truck, whether for commercial use or as an owner/operator, prospective buyers will encounter the TLG 075 form— a comprehensive credit application essential for facilitating the purchasing process. This form serves as a gateway for individuals looking to establish a line of credit with The Larson Group's various dealership locations, including Peterbilt of Springfield, Peterbilt of Joplin, and several others across different states, ensuring their vast accessibility. The application meticulously gathers personal information, including social security numbers, marital status, employment history, and residence details to secure a thorough background check. Additionally, it dives into the financial realm, requesting specifics on assets, liabilities, and even truck usage intentions, painting a detailed picture of the applicant's financial health and operational plans. It requests detailed employment and residential history spanning five years, alongside data on marital status, spousal employment, and references to aid in a comprehensive credit assessment. Furthermore, the form includes sections for insurance requirements and bankruptcy declarations, illustrating its role in not only assessing creditworthiness but also managing risk. The TLG 075 form, updated as of February 24, 2011, closes with a declaration of accuracy under penalty of law and spots for applicant signatures, underscoring the seriousness and legal bearings of the information provided. This essential document bridges the gap between ambitious drivers or trucking companies and their potential new Peterbilt vehicle, highlighting the importance of precision and truthfulness in its completion.
| Question | Answer |
|---|---|
| Form Name | Form Tlg 075 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | TLG 075 Capital_Lending_Cre dit_Application _03 30 2006 the larson group capital lending strafford mo form |
PETERBILT OF SPRINGFIELD |
PETERBILT OF JOPLIN |
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STRAFFORD, MO |
JOPLIN, MO |
O’FALLON, MO |
PETERBILT OF LOUISVILLE |
PETERBILT OF FT. SMITH, LLC |
PETERBILT OF ST LOUIS |
JEFFERSONVILLE, IN |
VAN BUREN, AR |
SAUGET, IL |
PETERBILT OF CINCINNATI |
PETERBILT OF N. KENTUCKY |
PETERBILT OF EVANSVILLE |
CINCINNATI, OH |
ERLANGER, KY |
EVANSVILLE, IN |
TRUCK COMPONENT SERVICES |
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TLG TRUCK |
STRAFFORD, MO |
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KANSAS CITY, MO |
CAPITAL LENDING CREDIT APPLICATION
Fax Number: (417)
PERSONAL INFORMATION
NAME: FIRST |
MIDDLE INITIAL |
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LAST |
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SOCIAL SECURITY NUMBER: |
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DATE OF BIRTH: |
MARITAL STATUS: |
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Unmarried (single, widowed, divorced) |
Married |
Separated |
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ADDRESS: |
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HOME PHONE NUMBER: |
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CITY, STATE, ZIP: |
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HOW LONG AT THIS ADDRESS? |
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EMAIL ADDRESS(S) |
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FORMER ADDRESSES (5 YEAR MINIMUM): |
CITY, STATE, ZIP: |
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DATE OF APPLICATION
NO. OF DEPENDENTS
CELL PHONE NUMBER:
HOW LONG IN AREA?
HOW LONG?
SPOUSE’S NAME (FIRST, M.I., LAST):
SPOUSE’ EMPLOYER:
BUSINESS NAME:
BUSINESS ADDRESS (IF DIFFERENT FROM ABOVE):
DATE OF BIRTH:
POSITION(S) HELD:
SOCIAL SECURITY NUMBER:
HOW LONG?
BUSINESS TAX I.D. NUMBER:
BUSINESS PHONE NUMBER:
EMPLOYMENT HISTORY FOR PAST FIVE YEARS (Present or Last Employer First)
NAME AND ADDRESS OF COMPANY:
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2.
3.
NEAREST RELATIVE NOT LIVING WITH YOU: SELF:
SPOUSE:
HAVE YOU EVER TAKEN BANKRUPTCY?
No |
EXPLANATION:
PHONE NO: |
POSITION(S) HELD: |
HOW LONG? |
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ADDRESS: |
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RELATIONSHIP: |
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ARE YOU A DEFENDANT IN ANY LEGAL ACTION? |
HAVE YOU EVER HAD ANY ITEM REPOSSESSED? |
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No |
No |
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TRUCK USAGE
HOW LONG AS OWNER/OPERATOR: |
OPERATOR LICENSE NUMBER: |
STATE: |
DATE: |
PURCHASER TO DRIVE? |
IF NO, PROVIDE INFORMATION BELOW OF |
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No |
PERSON WHO WILL DRIVE TRUCK. |
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DRIVER’S NAME (FIRST, M.I., LAST): |
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ADDRESS: |
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YEARS OF EXPERIENCE: |
OPERATOR LICENSE NUMBER: |
STATE: |
DATE: |
SOCIAL SECURITY NUMBER: |
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TRUCK TO WORK FOR – COMPANY NAME: |
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ADDRESS: |
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PHONE NUMBER: |
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IF TRUCKING – BETWEEN WHAT POINTS: |
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OFF HWY USE: |
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AVE MILEAGE PER MONTH |
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Yes |
NO |
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FIRE, THEFT, CAC AND COLLISION INSURANCE IS REQUIRED |
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NAME OF AGENT: |
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ADDRESS: |
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PHONE NUMBER: |
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NAME OF COMPANY |
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ADDRESS |
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COVERAGE TO BE SUBJECT TO MILEAGE RESTRICTION |
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No |
Yes, Radius: |
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1 of 2 |
BALANCE SHEET (Attach additional sheets if necessary)
ASSETS (What you own)
Cash on Hand & in Banks Accounts Receivable Equipment Owned/Leased
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LIABILITIES (What you owe) |
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Accounts Payable |
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Loan/Mortgage Information |
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Company |
City/State |
Phone. No. |
Acct. No. |
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Vehicles Owned
Company |
City/State |
Phone No. |
Acct. No. |
Real Estate: |
Own |
Monthly Payment:_______________
Rent
Company |
City/State |
Phone No. |
Acct. No. |
Other Assets (Itemize)
Other Debts (Itemize)
Total Assets
Total Liabilities
Net Worth
Total Liabilities & Net Worth
CREDIT REFERENCES (List Credit References on Paid Accounts)
NAME: |
CITY/STATE: |
PHONE NO.: |
CONTACT PERSON: |
ACCT. NO.: |
HIGHEST BALANCE: |
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2. |
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3. |
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BANK REFERENCE NAME: |
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CITY/STATE: |
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ACCOUNT NUMBER: |
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I/We understand and agree that you may assign or transfer this credit application and may also communicate the information contained herein to others to decide whether or not to extend credit. I/We authorize the bank and business references, as well as any of my/our lessors, landlords and any other past creditors to give any and all necessary information to you, your assignees or transferees, which will assist you in your credit inquiry. This application is given for the purpose of obtaining credit. I/We hereby certify under penalty of law that the foregoing is a true and complete statement of my/our financial condition. In the event of any material change in my/our financial condition, I/We will notify you immediately in writing. This shall be a continuing authorization for all present and future disclosures of account information and credit experience and credit inquiries.
X |
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X |
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Signature |
Date |
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Signature |
Date |
INSURANCE QUOTES REQUESTED
PHYSICAL DAMAGE – Deductible: |
$500 |
$1000 |
$1500 |
Other:___________ |
Cargo
Downtime
Driver Benefits
Disability
Term Life
Credit Life
Single Premium Annuity
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