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All Roads Universal Credit Application
All Roads Universal Credit Application
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2022-11-16T13:32:34+00:00
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Step
1
of 3
Legal Business Entity Name
*
Business Trade Name or DBA (Doing Business As)
Principal Owner
*
Description of Business
*
Your Business Website
Type of Business
Body Shop
Commercial Fleet
Government Entity
Mechanical Shop
Car/Truck Dealer
Other
Which All Roads business unit are you seeking a credit account with?
*
All Roads Trucks (includes Kenworth, PACCAR, Paclease, Cummins, Isuzu, Ford Commercial Trucks, Beavers’ Auto Body, RMS Truck Bodies)
All Roads Automotive (includes Ford Parts, Honda Parts, Acura Parts)
Packer Norris Parts (includes Ford Parts, Motorcraft)
Vermeer All Roads (includes Vermeer, Sherrill Tree, Yanmar, Fecon Lines)
All Roads Kubota (includes Kubota, Wright, Exmark, Ferris)
JG Parks & Son (includes engine parts, fuel injection components, Bosch, Denso, John Deere, CAT Marine, Deutz, Eaton)
Select all that apply.
Interested In:
*
Parts Purchasing
Mechanical Services
Equipment Rentals/Purchase
Truck Rentals
Requested Credit Limit
*
Does your business require Purchase Orders?
Yes
No
Your Full Name
*
Must be authorized representative.
Your Title
*
Your Email
*
Your Phone
*
Next
Business Classification
Sole Proprietor
Partnership
LLC
Corporation
Government/ Municipality
Non-Profit
State of Incorporation
*
Alabama
Alaska
Arizona
Arkansas
California
Canal Zone
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Where legal business entity was formed.
Years in Business
Federal Tax ID
*
Social Security Number
Estimated Annual Sales ($)
Number of Employees
Has your business ever had credit with an All Roads entity before?
Yes
No
Prior bankruptcy?
No
Yes, personally
Yes, current business
Yes, prior business
Is your business tax exempt?
Yes
No
Requires documentation.
REQUIRED – Please submit proof of tax exempt status.
Click or drag files to this area to upload.
You can upload up to 3 files.
Allowed file extension: .pdf, .doc, .png, .jpg, .jpeg, .gif, .docx
Business Contact Information
Billing Contact Name
*
Billing Contact Phone
*
Billing Contact Email
*
Billing Address
*
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
# of Years at Current Location
Own or Rent?
Own
Rent
Mortgage Company Name or Landlord Name
Same Contact?
Shipping Contact is the same as the Billing Contact.
Shipping Contact Name
Shipping Contact Phone
Shipping Contact Email
Shipping Address
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Business Reference #1
Please Note: business references submitted below cannot be a related party (i.e. maintain shared or similar ownership).
Business Reference Name 1
*
Business Reference Phone Number 1
*
Business Reference Email Address 1
*
Business Reference #2
Business Reference 2 Name
*
Business Reference 2 Phone Number
*
Business Reference 2 Email Address
*
Business Reference #3
Business Reference 3 Name
Business Reference 3 Phone Number
Business Reference 3 Email Address
Banking Reference
Name of Bank
Bank Contact Name
Bank Contact Phone
Bank Contact Email
———————–
Any Additional Comments for All Roads
Terms and Conditions
*
By submitting this Credit Application, I agree to the following Terms and Conditions:
*
I represent that the above information included in this Credit Application is true, correct, and complete and is for the purpose of obtaining credit from All Roads Company, LLC. All Roads Company, LLC and its affiliates and subsidiaries are collectively referred to herein as “All Roads”.
I represents that I have the authority to sign this Agreement on behalf of the business and that an online submission of this agreement shall be as binding as an originally signed and delivered document. A decision to grant or deny business credit requested of any company on this Credit Application will be made by All Roads. We may, in our sole discretion, refuse to extend business credit, goods, or services to you.
I acknowledge that I have read and fully understand the terms and conditions contained in this Credit Application.
I authorize All Roads and its representatives to contact references to verify information and give additional requested information to All Roads upon request.
I acknowledge that this Credit Application is for business customers only (including sole proprietorships) and credit provided in connection with this Credit Application may not be used to acquire equipment or services for personal, household or family purposes.
I further authorize All Roads to obtain a non-business consumer credit report in order to further evaluate the credit worthiness of the applicant as principal(s), proprietor(s) and/or guarantor(s) in connection with the extension of business credit as contemplated by this Credit Application.
I as (an) authorized individual(s) hereby knowingly consent to the use of such credit report consistent with the Federal Fair Credit Reporting Act as contained in 15 USC 1681 ct seq. should All Roads agree to be bound to the terms of this agreement.
I hereby personally guarantee any indebtedness incurred on the aforesaid account and attorney’s fees and cost incurred to enforce collection of the account and this Guaranty, and waive presentment and demand for payment, notice of non-payment, protest and notice of protest, and consents without notice of any extensions of time or increase in the amount of the credit given. This is intended to be a continuing guarantee and shall continue as to all new indebtedness incurred unless and until a written notice is served upon All Roads, by Certified Mail-Return Receipt Requested, declaring said guaranty shall not apply to future purchases.
Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has in good faith exercised any right under the Consumer Credit Protection Act. The Federal agency that administers compliance with this law concerning this creditor is the FTC Regional Office for the region in which CFCA or CFCA operates or the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580.
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