Print the form, fill it out, and mail or fax to:
MENDENHALL AUTO AUCTION, INC.
PO Box 7505 High Point, NC 27264
FAX: 1-336-889-4482
Print the form, fill it out, and mail or fax to:
MENDENHALL AUTO AUCTION, INC.
PO Box 7505 High Point, NC 27264
FAX: 1-336-889-4482
AFC Automotive Finance Corporation floor
planning
Confidential Dealer Application
Company Legal Name________________________________
Corporation ____________ Partnership __________ Sole Proprietorship___________ DBA____________
Federal ID#_____________________ Years in Business________________
Sales Tax # ____________________
Line Requested $________________________
Dealer License # _______________________________ Expiration Date ___________________
Retail____ Wholesale _____ Other______
Street Address______________________ County______________________
City _______________________ State______________ Zip Code _________________
Years There ______________________ Own _________ Rent _________
Phone ________________________________ Fax ____________________________________
(if dealership is a corporation list officer info, otherwise list owner info)
Name _______________________________ Title
__________________ Home Tel # __________________
Home Address _________________________________________________________________________
Own ________ Rent ________ SS# ________________________ DOB ____________
Dr. License # _______________________ Ex. date _________________
Name _______________________________ Title
__________________ Home Tel # __________________
Home Address _________________________________________________________________________
Own ________ Rent ________ SS# ________________________ DOB ____________
Dr. License # _______________________ Ex. date _________________
Business Bank Information
Bank Name _______________________________ Acc't # _______________________________
Bank Phone ________________________________
Trade Creditors
Name _____________________________________ Phone # _____________________________
Name _____________________________________ Phone # _____________________________
Auction References
1.____________________________________________________________________________
2.____________________________________________________________________________
Other floorplan Sources
1. ___________________________________________________________________________
2. ___________________________________________________________________________
Insurance
Agents Name _______________________________ Phone # ___________________________
Full Coverage ________________________ Liability Only ______________________________
I hereby certify the information contained within this
application and on any accompanying financial statements is true, complete, and accurate.
I authorize AFC to obtain credit information from a credit bureau, and any financial
institution or trade creditor that I have provided as well as any other credit
investigation that AFC in AFC's sole discretion deems necessary. I also authorize AFC to
contact any third parties and to disclose information, including information contained in
this application, for the purpose of, among other things, obtaining intercreditor
agreements and perfecting AFC's sercurity interest.
Further information may be required on approved applications.
Signature ________________________________________________ Date ________________
Signature ________________________________________________ Date ________________
CALENDAR PUBLIC INFO DEALERS MAIN PAGE