Business Credit Application - Lake Powell Ford -

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Business Credit Application – Lake Powell Fordadamgillrie2025-05-15T18:41:48+00:00

Step 1 of 16

6%

Name*
First Last
Date of Birth (For Individuals)*
DBA

DBA means "doing business as" and is also referring to as your business's assumed, trade or fictitious name.
Business Type
- Proprietorship
- Corp.
- Sub S
- LLC
- Partnership
- Other
Other

Are you tax exempt?
- No
- Yes
Tax Exempt Number

If you are tax exempt please provide your tax exempt number.
State-issued Organization # (not tax id #):
State of Organization or state of legal residence for individuals
State
SOC SEC # /TAX ID #

Gross Profit (Monthly Income
Type of Business
Years in Business
Business Email
Business Website

Primary Legal/CEO Address
Street Address Address Line 2 City State ZIP Code
County
Is your billing address different from above?
- No
- Yes
Billing Address (If Different from above)
Street Address Address Line 2 City State ZIP Code
Billing County (If different from above)

Do you have a Fleet Manager?
- No
- Yes
Fleet Manager Name
First Last
Fleet Manager Phone Number
Fleet Manager Email

Do you have a separate Garage?
- No
- Yes
Garage Address:
Street Address Address Line 2 City State ZIP Code
Garage Country
Garage Phone Number
Garage Fax Number
Garage Mobile Phone
Garage Contact Name
First Last

Owner/Guarantor: Name
First Last
Title
Owner/Guarantor Address:
Street Address Address Line 2 City State ZIP Code
Owner/Guarantor Phone
Social Security Number / TN#
Owner/Guarantor Date of Birth
Ownership %

Is there an additional Owner/Guarantor?*
- No
- Yes
2nd Owner/Guarantor: Name
First Last
2nd Owner Title
2nd Owner/Guarantor Address:
Street Address Address Line 2 City State ZIP Code
2nd Owner/Guarantor Phone
2nd Social Security Number / TN#
2nd Owner/Guarantor Date of Birth
2nd Ownership %

Are you a Sole Proprietor, Individual Co Applicant(s) or Individual Guarantor(s)?
2nd Owner/Guarantor: Name
Prefix First Middle Last Suffix
Social Security Number
Date of Birth
MM slash DD slash YYYY

Home Phone
Home
- Own Home Outright
- Buying Home
- Living with Relatives
- Leasing/Renting
Lived There for How Many Years
Lived There for How Many Months
Drivers License Number
State Issued
State

Have you been at your current business for more than 2 years?
- No
- Yes
Previous Employer
Previous Employer Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Previous Employer's Phone #
Monthly Income
Secondary Income*
*Alimony, child support or separate maintenance income need not be revealed if you do not with to have it considered as a basis for repaying this obligation.
Secondary Income Source

Mortgage Holder / Land Lord Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mortgage Holder / Land Lord Phone #
Mortgage Payment / Monthly Rent

Name of nearest relative not in household
Address of nearest relative not in household
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Relatives Phone #

Name of non-related personal reference known over 1 year
Address of non-related personal reference known over 1 year
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Home Phone

Have you previously done business with Ford Motor Credit Company?
- Yes
- No
What Account# ?

List Other Creditors you do business with
Trade
Trade City & State
City State
Trade Phone
Trade Contact
Account #