Online Credit Application

ONLINE CREDIT APPLICATION

Equipment Type

Which type of equipment are you interested in leasing?*

Chassis Containers Trailers

Are you a UIIA member?*

Yes No

Proof of Certificate of Insurance required if application approved.

Who is the Milestone Sales Representative you are working with (If not working with anyone, enter None)?* Who is the Milestone

Insurance Requirements

Milestone requires the following Primary insurance coverages:

- Auto Liability of $1 Million
- Commercial General Liability of $1 Million
- Physical Damage/Trailer Interchange Coverage

In lieu of Physical Damage Coverage, you may elect to select our Loss Damage Waiver (LDW) program (available on Trailers only).

Would you like more information on our LDW program?*

Yes No

Interest in our LDW program is NOT your election to select the program. If you choose to select the LDW program, an addendum will be present for your signature to confirm your election into the program.

Headquarters Address

Headquarters Address 1 *

Headquarters Address 2

Headquarters City *

Headquarters Zip Code *

Use this address as my Billing Address*

Yes No

Use this address as my Mailing Address*

Yes No

Is this address the same physical address where owned/leased equipment is located?*

Yes No

Billing Address

Billing Address 1 *

Billing Address 2

Billing City *

Zip Code *

Mailing Address

Mailing Address 1 *

Mailing Address 2

City *

Zip Code *

Physical Address of Owned/Leased Equipment

Physical Address 1 *

Physical Address 2

Physical City *

Zip Code *

Principal(s) / Beneficial Owners - Legal ownership information is a requirement of Know Your Customer compliance under the USA Patriot Act.

Company or Entity Name *

First Name *

Last Name *

Middle Name *

Suffix

Country of Citizenship *

Tax ID Number *

Social Security Number

Ownership Share Percentage *

Street Address 1 *

Street Address 2

City *

Zip Code *

Is there another legal owner with 25% or more ownership?*

Yes No

Related Companies Information

Company Name

Street Address 1

Street Address 2

City

Zip Code

Please describe the affiliation with this related company Maximum 300 characters allowed

Is there another related company?

Yes No

Trade Reference 1

Company Name *

Street Address 1

Street Address 2

City

Zip Code

Contact Name

Contact Phone *

Contact Email Address

Trade Reference 2

Company Name *

Street Address 1

Street Address 2

City

Zip Code

Contact Name

Contact Phone *

Contact Email

Bank References

Bank Name *

Street Address 1

Street Address 2

City

Zip Code

Account Number

Contact Name

Contact Phone

Contact Email Address

Would you like to add another bank reference?*

Yes No

Operating Line of Credit

Bank Name

Approved Line Amount

Outstanding Balance

Contact Name

Contact Phone Number

Contact Email Address

Top Haul Customers

Customer 1 Name

Percentage of Business

Customer 2 Name

Percentage of Business

Customer 3 Name

Percentage of Business

Fleet Stats

Fleet Size - Drivers *

If none, please enter N/A

Fleet Size - Power *

If none, please enter N/A

USDOT Number *

If none, please enter N/A

MC Number *

If none, please enter N/A

Equipment Usage

Do you intend to use the equipment outside the U.S.?*

Yes No

Please check all countries that apply?*

Canada Mexico

Please select at least one country

W-9 Form

Upload your W-9 Form by clicking CHOOSE FILE*

CHOOSE FILE W-9 Form File Maximum file size is 2MB

Sign & Submit Application

Milestone shall determine, in its sole discretion (i) whether to accept Company as a customer, (ii) whether a guarantor shall be required, if any, (the “Guarantor”), and (ii) the maximum number of units of equipment which may be rented or leased by Company under Rental/Lease Agreement, as such term is defined below. Company understands that Milestone may retain this Application whether or not it is approved.

Upon such determination, in order to rent/lease equipment from Milestone, (i) Company shall enter into an equipment rental and/or lease agreement with Milestone for the possession, use, operation but not ownership of, the equipment (in either event, the “Rental/Lease Agreement(s)”) and (ii) Guarantor shall enter into a guaranty agreement for the benefit of Milestone which Guarantor guaranties the payment and performance of Company under the Rental/Lease Agreement(s) (the “Guaranty”).

The undersigned is/are the [legal owner(s) and/or authorized officer] of Company and by my/our signature(s) below, I/we hereby execute this Equipment Leasing Application (this “Application”) for myself/ourselves and on behalf of Company, and further:

Certifies that all of the foregoing information and other information provided to Milestone in furtherance of this Application is true and correct (under the penalties of perjury) and shall remain true and correct on the date of the Rental/Lease Agreement(s) and any Guaranty. To the extent any of the information is not correct or shall become untrue, including but not limited to changes in ownership [and changes in haul sources], Company and/or the legal owner(s) shall notify Milestone immediately of such misstatement(s) and/or change(s) in writing. Failure to provide such update may result in the abandonment of this Application without penalty or premium to Milestone or additional credit review of the Company, in each case, at Milestone’s sole discretion.
Milestone will utilize any of its third-party vendors to whom Milestone may rightfully refer this Application to investigate and review Company’s creditworthiness (collectively, the “Reviewer Parties”), as of the date hereof and through the term of any Rental/Lease Agreement, to (i) request and require a credit report with respect to Company, and/or Guarantor(s) (if any), and each of their respective credit history(ies) (ii) contact Company’s creditors, and (iii) request and obtain insurance information and evidence of insurance from Company’s insurance company(ies).
Authorizes the Reviewer Parties to share this Application and Company’s related information in Milestone’s possession in connection herewith with any affiliates of Milestone or any potential counterparties engaged in any discussion(s) contemplating the assignment, transfer, sale or any other disposition of any Rental/Lease Agreement which may arise from this Application.
Authorizes the Reviewer Parties to answer any and all third-party questions related to Milestone’s credit experience with Company.

This Application may be executed and delivered by electronic (facsimile, email, .pdf or otherwise) transmission shall constitute effective execution and delivery hereof and all purposes and signatures hereto transmitted and/or produced electronically shall be deemed to be their original signature for all purposes. Each of the undersigned, on behalf of each undersigned and Company, hereby agree with the all of the foregoing and certify all information provided herein to be true and correct as of the date hereof and, except as otherwise updated by Company in writing to Milestone, shall be true as of the date of the Rental/Lease Agreement and Guaranty.

First Name *

Last Name *

Title *

Signature*

Use your mouse or finger to draw your signature in the box below. Click the Clear button to erase and re-draw.

CLEAR

Date *

Online Credit Application