CREDIT APPLICATION.

Powell's sales staff is the best in the business when it comes to getting you what you need at the price you want. Powell's Truck & Equipment is an authorized dealer of International and Isuzu Trucks, and has a full service center and body shop. We carry a large variety of parts and can order the parts you need to get your truck back on the road. Powell's Idealease is an authorized Idealease vendor in Lynchburg, Virginia.

Please fill in all required fields.

Apply for Financing

Applicant (Legal Company Name) Applicant (Legal Company Name)

Proprietorship, partnership, corporation, other Proprietorship, partnership, corporation, other

FEI# (If any) FEI# (If any)

Address Address

City City

County County

State State

Zip Zip

Phone Phone

Fax Fax

Mobile Phone Mobile Phone

Email Email

Website Website

Equipment will be located at Equipment will be located at

Type of business Type of business

Time in business under current ownership Time in business under current ownership

At this location At this location

Owner Name Owner Name

Title Title

% of ownership % of ownership

Home Address Home Address

Rent/ Own Rent/ Own

Multiple Owners? (List additional owners here) Multiple Owners? (List additional owners here)

Equipment to be financed Equipment to be financed

New / Used / Age New / Used / Age

Equipment Cost ($USD) Equipment Cost ($USD)

Banking Reference Banking Reference

Contact (Banking Reference) Contact (Banking Reference)

City & State City & State

Phone Phone

Type of account Type of account

Loan or lease reference (originator, contact, phone) Loan or lease reference (originator, contact, phone)

Trade reference (Originator, contact, phone) Trade reference (Originator, contact, phone)

Sign (Please print your full name) Sign (Please print your full name)

Date Date

Choose the heart:

Choose the moon: