Truck Application

Contact
Information

Personal
Information

Financial
Information

Driving
& Usage

Sign
Application

*Fields marked with asterisk(*) are required

Contact Information

First Name*

Middle Initial

Last Name*

Suffix

Email Address*

Phone Number*

Address Information

Street Number*

Street Name*

Street Suffix

Apt or Lot #

City*

State*

Zip*

Do you rent, own, or live with a relative?*

Personal Information

Date of Birth* format: MM/DD/YYYY

Marital Status*

Number of Dependents enter a number or "0" for none

Financial Disclosures

I am currently involved in a Legal Action (e.g. Divorce, Bankruptcy, Foreclosures, etc.).

I have Unpaid Tax Liens.

If so, how much?*

I have Past Due Marital or Child Support.

If so, how much?*

Monthly financial obligations

Monthly housing payments (rent, mortgage or shared expenses)

Monthly secured loan payments (vehicle, motorcycle, boat, ATV, etc.).

Other monthly payment obligations (child support, alimony, other).

Other monthly income amounts (spousal income, pension, retirement).

Current Driving Information

Motor Carrier Name / Employer Name*

Most Recent Driving Experience*

Start Date*
format: MM/DD/YYYY

This is my current job.

End Date*
format: MM/DD/YYYY

If no longer there, why did you leave?*

Previous Employment Information

In the last two years, how many jobs have you had? (Include unemployment over 30 days.)*

I have had my CDL for at least six months.

What is the term on your DOT Medical Card?*

Have you had owner-operator experience?

Truck Usage

What Motor Carrier do you intend to operate for?*

Other Motor Carrier name

What type of haul will you do with the truck?*

Will the haul be solo or team?*

How much money down are you able to provide?

How did you hear about us

Name of SFI client that referred you.

Did you speak with an SFI Rep?

Where did you hear about SFI?

Authorized Signature

Social Security* format: 000-00-0000

By signing below and submitting this application, I make the following certifications, authorizations and acknowledgements with regard to this application to Schneider Finance, Inc. ("SFI") for vehicle lease/financing:
I certify that I am an owner of the applicant identified above in the "NAME" section of this application (the "Applicant"), and that I am authorized to submit this application on behalf of the Applicant and to legally bind the Applicant. I certify that the information I provided in this application is true and correct to the best of my knowledge. I further certify that any lease or financing that may result from this application, and any vehicle so leased or financed, will be used exclusively for the Applicant's business or commercial purposes. I understand that this application will be retained by SFI regardless of whether it is approved.
On behalf of the Applicant and on my own behalf, I hereby authorize SFI to verify my employment history, and to contact credit bureaus and other third parties to make inquiries in evaluating this application, or in connection with any update, renewal, or extension of the credit or lease for which this application was made, including requesting business credit reports on both the Applicant and on me, and requesting consumer reports on me from consumer reporting agencies. If I ask SFI whether my consumer report was requested, SFI will inform me and, if applicable, will provide me with the name and address of the consumer reporting agency that furnished the report. I further authorize SFI to answer questions about its transactions or experiences with me. I acknowledge that I have read the Authorization to Transmit Information and authorize SFI to exchange information with my motor carrier pursuant to that Authorization.

Date: