Credit Application Application Date WCC REP Borrower/Lessee (DBA if Applicable) Business Established Nature of Business Fed Tax ID # Incorporated Telephone # Fax # Street City State & Zip Contact Title County Management All owners, officers or partners(authorized to act for Borrower/Lessee) 2022 Personal Income Name and Title S.S. # Home Address City State Zip Tel. 2023 Personal Income Net Worth $ Name and Title S.S. # Home Address City State Zip Tel. Net Worth $ Equipment Description Vendor Name Rep. Tel. Fax Term Months Cost $ Banking & Lending References (Please attach copies of the summary sheet of your last 3 months checking account statements) 1. Bank Branch Checking # Tel. Contact Avg Balance 2. Bank Branch Checking # Tel. Contact Ave Balance Trade References 1. Name Phone Contact 2. Name Phone Contact Date Bank Statments Send