For the purposes of establishing and maintaining credit, the undersigned submits the foregoing statement and information contained on this application, both written and printed, as being a full, true, and correct statement of my financial condition and all above matters, on the date stated. The undersigned agrees to notify Mid-States Utility Trailer Sales, Inc., and any affiliates which have or intend on providing credit or financing, immediately in writing of any materially unfavorable change in my financial condition of the above matters, and in the absence of such notice or a new and full written statement, all matters herein may be considered as a continuing statement and substantially correct.
The undersigned hereby authorizes Mid-States Utility Trailer Sales, Inc. and/or any of its affiliates to make inquiry into, to request, to obtain credit reports, and to receive any information concerning my character, general reputation, personal characteristics, mode of living, and all information from creditors which Mid-States Utility Trailer Sales, Inc. and/or any of its affiliates deems relevant for the granting and collection of the proposed borrowing or credit account. This authorization shall be effective from the date upon which this application is signed and is a continuing authorization for all present and future disclosures of account information and credit experience on Applicant made by Mid-States Utility Trailer Sales, Inc. and/or any of its designated affiliates, or any person requested to release such information to Mid-States Utility Trailer Sales, Inc. and/or any of its designated affiliates. Upon my request, additional information as to the scope of this inquiry, if one is made, will be provided. I further represent that neither the undersigned, any principal officer of the undersigned, 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 any felony.
I understand that Mid-States Utility Trailer Sales, Inc. and/or any of its designated affiliates, or any person requested to release such information to Mid-States Utility Trailer Sales, Inc. and/or any of its designated affiliates will be relying on the accuracy of the matters set forth herein as a basis for extending any credit which I may receive.
Authorization for release of Information:
For the purpose of obtaining credit, the undersigned authorizes Mid-States Utility Trailer Sales, Inc. and its affiliates or assigns, (referred collectively as MSUTS) to conduct inquiries regarding the undersigned's business and individual credit histories as it may deem necessary including, without limitation, requesting credit bureau reports, contacting Banks, secured lenders, lessors and trade creditors. I / We authorize all parties contacted by MSUTS to verify the information contained in this application, and to release credit and financial information requested as part of said verification. I / We agree that anyone receiving a fax or photocopy of this document may act in reliance thereon. This application for credit is for business and not for personal, family, or household purposes.
