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BUSINESS CREDIT APPLICATION

SECTION 1: BUSINESS APPLICANT

Company Information

Sole ProprietorPartnershipLimited Liability CompanyCorporationOther


State of Formation: Date of Entity Formation: Federal Tax ID: Industry:

Business Name:
Previous Company Names or DBA's:
Owner/GM Contact: Phone Number: Email:
Purchasing Contact: Phone Number: Email:
Maintenance Contact: Phone Number: Email:
AP Contact: Phone Number: Email:
Street Address: City: State: Zip: Phone Number:
Billing Address: City: State: Zip: Phone Number:
Years in Business: Trading: PublicPrivateN/A
Tax Exempt: YesNo Upload your tax exempt certificate: (2mb limit, JPG, PDF, or JPEG files accepted)

SECTION 2: CREDIT REFERENCES

Business Name:
Previous Company Names or DBA's:
Bank: Loan Officer:
Credit References
Name & Relationship: Phone Number:

SECTION 3: EQUIPMENT LOCATION

Street Address: City: State: Zip: Phone Number:

SECTION 4: INSURANCE FOR EQUIPMENT

Name of Insurance Company: Contact: Phone: Policy No.: Expiration:
If self-insured, does applicant have a contingent policy? YesNo If yes, please provide details:

FAIR CREDIT REPORTING ACT (FCRA DISCLOSURE)

If the undersigned is an individual or sole proprietor: This application for credit will be submitted to Toyota Motor Credit Corporation ("TMCC") at 19001 S. Western Ave, Torrance, CA 90501 for consideration as to whether it meets purchase requirements.

SIGNATURE

The undersigned agrees, represents and warrants as follows with respect to themselves alone and with respect to the information related to themselves alone. This completed form is furnished to TMCC in connection with an application for financing a business purchase or lease of commercial use equipment or vehicle(s) and TMCC will rely on the information furnished in connection with this application in making its decision. The undersigned represents and warrants that all information contained in the above application and in all financial statements or other information provided to TMCC in connection with this application, is complete, true and correct, and accurately represents the financial condition of the undersigned. The undersigned has no knowledge of any liabilities, contingent or otherwise, not reflected in this application or any of the financial statements provided to TMCC in connection with this application. Since the date of the most recent financial statements furnished to TMCC in connection with this application, there have been no materially adverse changes in the financial condition of the subject of the statements. If the undersigned is an individual or sole proprietor, the undersigned further agrees as follows: I authorize TMCC to investigate my credit and employment history and to obtain a consumer credit report on me from one or more credit reporting agencies. If credit is granted, I authorize TMCC to obtain subsequent consumer credit reports on me in connection with any update, renewal or extension of credit, collection of the account, or other legitimate business purposes associated with the account, and to release information about its credit experience with me to others as permitted by law.

Business Applicant Name: Date:
By:
Title:

California

If the applicant is a married individual or registered domestic partner, applicant may apply for credit separately.

New York

If you are an individual, a consumer report may be requested in connection with this application. Upon your request, you will be informed as to whether or not a consumer report was requested and informed of the name and address of the consumer reporting agency that furnished the report. On any update renewal or extension of this credit, subsequent consumer reports may be requested.

Ohio

The Ohio laws against discrimination require that all creditors make equally available to all creditworthy customers and that credit reporting agencies maintain separate credit histories on each individual upon request. The Ohio Civil Rights Commission administers compliance with this law.

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