CREDIT APP RCI ASSET MANAGEMENT INC Application Type Application type App title Tax Personal Information — Primary Applicant First name Middle name Last name Email License number License state License date Date of birth Age Social security Dependents Phone business Phone residence I agree to receive text messages from RCI Trucks and National Truck Finance about my inquiry, application and account. Message frequency varies. Msg & data rates may apply. Reply STOP to opt out, HELP for help. Consent is not a condition of purchase or financing. SMS Terms and Privacy Policy. Spouse Spouse full name Spouse date of birth Spouse age Spouse social security Current Address Address line 1 Address line 2 City State Zipcode Residence length Own rent Rent paid to Former Address Former address line 1 Former address line 2 Former city Former state Former zipcode Corporation Information Corporation name Incorporated state Incorporated date Principal Principal age Principal title Principal owned Principal 2 Principal age 2 Principal title 2 Principal owned 2 Nearest Relatives not at Above Address Relative name Relative address Relative city Relative state Relative phone Relative relation Relative name 2 Relative address 2 Relative city 2 Relative state 2 Relative phone 2 Relative relation 2 Relative name 3 Relative address 3 Relative city 3 Relative state 3 Relative phone 3 Relative relation 3 Relative name 4 Relative address 4 Relative city 4 Relative state 4 Relative phone 4 Relative relation 4 Employment — Past & Present — Five Years Past company name Past contact name Past contact phone Past contact address Past contact position Past contact how long Past company name 2 Past contact name 2 Past contact phone 2 Past contact address 2 Past contact position 2 Past contact how long 2 Past company name 3 Past contact name 3 Past contact phone 3 Past contact address 3 Past contact position 3 Past contact how long 3 Owner operator duration Nature of business Gross monthly income Trade-in Description — Truck Truck year Truck make Truck model Truck engine Truck transmission Truck rears Truck sleeper Truck serial number Truck condition Truck title state Truck months in loan Truck amount owed Truck payment amount Truck other info Truck trailer Trade-in Description — Trailer Trailer year Trailer make Trailer model Trailer length Trailer width Trailer height Trailer serial number Trailer condition Trailer title state Trailer months in loan Trailer amount owed Trailer payment amount Trailer other info Purchase Item Description Purchase item year Purchase item make Purchase item model Purchase item stk Truck trailer Purchase item notes Purchase item note Bank / Assets Bank description Bank bank Bank phone Bank account Bank asset value Bank payment amount Bank amount you owe Bank description 2 Bank bank 2 Bank phone 2 Bank account 2 Bank asset value 2 Bank payment amount 2 Bank amount you owe 2 Bank description 3 Bank bank 3 Bank phone 3 Bank account 3 Bank asset value 3 Bank payment amount 3 Bank amount you owe 3 Bank description 4 Bank bank 4 Bank phone 4 Bank account 4 Bank asset value 4 Bank payment amount 4 Bank amount you owe 4 Bank description 5 Bank bank 5 Bank phone 5 Bank account 5 Bank asset value 5 Bank payment amount 5 Bank amount you owe 5 Sign & Date Bankruptcy Repossessed Signed date Signed by Signed title Signed email SECURE SUBMISSION
