Credit Application

Business Information

Legal Company Name

Legal company name is required.

Years in Business?

Email Address

A valid email address is required.

City

Address

Address is required.

State

Zip

Contact Title

Equipment Location / Different from Above

Nature of Business

Phone Number

Fax Number

Federal Tax ID Number

UBI Number

Principal

Principal Partner / Officer / Guarantor #1

Name

Social Security Number

Home Street Address

City

Address

State

Zip

% Ownership

Phone Number

Title

Principal

Principal Partner / Officer / Guarantor #2

Name

Social Security Number

Home Street Address

City

Address

State

Zip

% Ownership

Phone Number

Title

Terms

Application Purpose Contact Lease

State

Type Proprietor Corp Organization Partnership

References

Bank & Finance Reference #1

Bank/Credit Reference Name

Contact

Account Number

Phone Number

Fax Number

City/State

Bank & Finance Reference #2

Bank/Credit Reference Name

Contact

Account Number

Phone Number

Fax Number

City/State

Trade Reference #1

Name

Contact

City/State

Phone Number

Fax Number

Trade Reference #2

Name

Contact

City/State

Phone Number

Fax Number

Insurance

Name

Contact

Phone Number

Fax Number

Work on Hand #1

Name

Contact

Phone Number

Fax Number

Work on Hand #2

Name

Contact

Phone Number

Fax Number

Authorization

WE AUTHORIZE DARLING SONS INTL. LLC, HEREAFTER KNOWN AS DSI, AND ANY AND ALL FINANCIAL INSTITUTIONS TO WHOM DSI SUBMITS THIS TRANSACTION FOR APPROVAL (LENDERS), TO MAKE WHATEVER CREDIT INQUIRIES THEY DEAM NECESSARY IN CONNECTION WITH A LEASE/LOAN APPLICATION. WE AUTHORIZE AND INSTRUCT ANY PERSON, TRADE REFERENCE, BANK, AND CONSUMER REPORTING AGENCY TO COMPILE AND FURNISH TO DSI AND LENDERS ANY INFORMATION THAT IT MAY HAVE OR OBTAIN IN RESPONSE TO SUCH CREDIT INQUIRIES AND AGREE THAT SUCH INFORMATION, ALONG WITH THE APPLICATION, SHALL REMAIN DSI AND LENDERS PROPERTY WHETHER OR NOT THE LEASE/LOAN APPLICATION IS APPROVED

Applicant #1

I certify this above authorization statement.

Signature

Sign here

Applicant #1 signature is required.

Title

Email Address

Date

Applicant #2

I certify this above authorization statement.

Signature (Optional)

Sign here

Applicant #2 signature is required when used.

Title

Email Address

Date