Online Credit Application Policy

Interstate-Truckway, Inc. is committed to protecting your privacy. The business and personal information that you submit through our online application will only be used for our own business purposes. We will not provide any of this information to others.

This online credit application does not obligate Interstate-Truckway, Inc. to provide the financing requested. The information that you provide on this online application is subject to verification.

If you have questions regarding our Privacy and Online Application Policy, email phyllisw@interstatetrailer.com

By filling out the form below, you acknowledge that you have read and understand this Interstate-Truckway Privacy and Online Application Policy.


Name (First M. Last)
Address
City
State Zip
Residence Years Months
Monthly Payment Status
  Previous Address (If less than 2 yrs at current)
Address
City
State Zip
Phone
Email
Social Security No.
  Driving Experience
Years Months
License #
Have you ever filed bankruptcy? No Yes
When?
Are you a defendant in legal action? No Yes
If yes, explain:
Have you ever had an item repossessed? No Yes
When?
  Business Information (If applicable)
Company
Address
City
State Zip
Phone
Federal I.D. No.
  Employment/Haul History (for the past 5 years)
Current Employer
Contact Person Phone
Years Employed? Months?
Monthy Income
Previous Employer
Contact Person Phone
Years Employed? Months?
  Truck To Work For (if not current employer)
Company
Contact Person Phone
Other Source of Income Montly Amount
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 this obligation.
  Bank References
Bank Name
City, State
Phone
Account Number
Account Number
  Tractor & Trailer Credit History
Lender Name
Lender Phone Balance
Account Number
Lender Name
Lender Phone Balance
Account Number
Lender Name
Lender Phone Balance
Account Number
Describe what you would like financed (make, model, price, etc.)
as well as any additional information you want to provide us:
I hereby certify and represent that the information contained in this online application is a full, true, and correct statement of my financial condition and all other matters on the date submitted.

I hereby authorize Interstate-Truckway, Inc. to make inquiry into, to request, and to receive, from the bank and credit references listed herein, from credit reporting agencies, and otherwise, any information concerning my credit worthiness, credit standing, credit capacity, credit experiences, accounts, character, general reputation, personal characteristics, mode of living, and all other information from creditors that Interstate-Truckway, Inc. deems relevant for the proposed borrowing. This authorization shall be effective from the date that this form is electronically submitted and shall expire automatically upon full payment of the present borrowing, if any is granted.

I further certify and represent that neither the applicant, any principal officer of the applicant, nor any contemplated operator of any equipment proposed to be purchased has any record or reputation of having violated any federal or state laws relating to liquor, narcotics or contraband; and no such person has been convicted of a felony.

I understand that Interstate-Truckway, Inc. and/or the seller of equipment, parts or services to whom this information is presented, will be relying on the accuracy of the matters set forth herein as a basis for extending any credit that I may receive.

Signed (Your Name)

Make sure your information above is accurate, then click to: