Loan Application

General information

First Name: *

Last Name: *

Date of birth:

E-mail Address: *

Phone Number: *

Fax Number:

SSN:

Next of Kin:

Residential Address Information

Street Address:

Unit, Suite or Apt:

City:

State/Province:

Zip/Postal code:

Time at Current Years

Residence: Months

Previous Address Information

Street Address:

Unit Suite or Apt:

City:

State/Province:

Zip/Postal code:

Time at Previous Years

Residence: Months

Mailing Address

Street Address:

Unit Suite or Apt:

If Different Than Residential Address (optional)

City:

State/Province:

Zip/Postal code:

Housing Information

Primary Residence: Own Rent Other

Total Years You Have Been a Homeowner:

Estimated Monthly Housing Payments: $

Include all mortgages or rent, property taxes, homeowners fees, and insurance

Employment Information

Employment Status:

Description:

Present Employer:

Time Employed: Years Months

Phone: Ext

City:

State/Province:

Zip/Postal code:

Street Address:

Mailstop, Suite or Floor:

Floor:

Gross Monthly Income: $ Monthly

Liquid Assets / Income / Expenses

Liquid Assets: $

Total of checking, savings, money market, stocks, bonds, and mutual funds. Please do not include equity in your home, retirement monies, restricted stock or unvested options

Other Monthly Income: $

Source of Other Monthly Income Alimony, child support, or separate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying your loan

Expenses & Liabilities: $

Credit Score or Range: $

Your Loan

Product Selected:

Type Selected:

Vehicle Motorized Type:

Vehicle Make:

Vehicle Model:

Current monthly payment: $

Loan Amount Requested: $ *

Term in Months: *

Down Payment: $ *

Do you have a vehicle you wish to trade in? Yes No

Optional Financing Referral Service

Motor Trucks Inc is committed to helping you finance your vehicle. In the event we are unable to provide you with a vehicle loan, we offer an optional service that could help you obtain financing.
Your financial application data or credit information will not be shared. We will forward only your intended make and model and contact information (name, address, phone number and e-mail address) to institutions who meet the criteria for your financing needs.

Yes No

Billing Choice

Please choose Automated Payment Option or Invoicing Payment Option.

Automated days

Invoicing days

Special Instructions

Please note any special time or range of times which you desire us to contact you, if different from above. We can contact you at any time during our regular business hours.

*- indicates required fields

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