Truax Seed Planting Equipment

	FLEXII Grass Drill
	FLEXII Grain Drill
	FLEXII Utility Drill
	Trillion Broadcaster
	Pull Type Broadcaster
	Rangeland Drill
	Seed Slinger
	Used Equipment

Equipment Financing

To help the government fight the funding of terrorism and money laundering activities, U.S. Federal law requires financial institutions to obtain, verify and record information that identifies each person (individuals or businesses) who opens an account. What this means for you: When you open an account, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.

Personal Data – Proprietor, Corporate Officer, Partner, General Partner (if a person), LLC Managing Member (if a person)
Name:
Work Title
Home Telephone
Date of Birth
Home Address
City
State
County
Zip Code
Social Security Number
Name:
Work Title
Home Telephone
Date of Birth
Home Address
City
State
County
Zip Code
Social Security Number
Applicant: (If a corporation, LLC, LP or other organization, use EXACT registered name.)
Applicant’s Name
Phone Number
Fax Number
Contact Person’s Cell No.
Contact’s Email Address
Primary Business or Farm Address
City
State
County
Zip Code
Proposed location/address of equipment/property:
City
State
County
Zip Code
General description of Applicant’s business:
In Business Since:
Business Type:	Sole Proprietorship For-Profit Corporation Non-Profit Corporation Limited Liability Co Limited Partnership General Partnership Other (List Type)
State of Organization/Registration
State Organizational ID Number
Federal Tax ID/SSN Number
Equipment Use:
FARM / AGRICULTURAL: %
COMMERCIAL: %
OTHER %. Please describe:
EQUIPMENT COST: $
Other Income: (Alimony, child support or maintenance need not be revealed if you do not wish it to be considered in determining your creditworthiness.)
Source of Other Income:
Amount: $
Per:	Month Year Other
Source of Other Income:
Amount: $
Per: Month Year Other	Month Year Other
COMPLETE THE SECTION BELOW IF YOU HAVE INCOME FROM AGRICULTURE.
Do you farm:	FULL TIME PART TIME
# OF ACRES OWNED
# OF ACRES RENTED
KIND OF CROP/LIVESTOCK
NO. OF ACRES
INCOME DATE
ESTIMATED AMOUNT
OTHER INCOME
SEASONAL INCOME
Bank/Credit References
Name (two year history
Account Number
Officer to Contact
Phone Number
Other Account(s)
Certification and Authorization of Individual(s) to Release Information: Each of the undersigned person(s), individually and on behalf of the above Applicant (collectively the “Signer”), hereby represents to Wells Fargo Financial Leasing, Inc., its subsidiaries and affiliates (collectively “WFFL”) that (a) all information provided to WFFL in connection with this credit application, including, without limitation, tax returns, financial statements, accountants’ statements and the information set forth above, is true and correct and (b) this application is made for the sole purpose of obtaining credit from WFFL for commercial or agricultural (and not for personal, family or household) purposes. Signer hereby authorizes WFFL and any of its affiliates and potential or actual assignees to obtain any business and/or personal financial information, from time to time, including, without limitation, information from any consumer reporting agency, credit bureau or other reporting source regarding Signer’s and/or Applicant’s credit history, for purposes of (i) evaluating this application, (ii) monitoring any and all leases, loans and other financial transactions entered into as a result of this application, (iii) extending, renewing or amending any such lease, loan or other contract, and/or (iv) evaluating any request by Signer or Applicant for additional credit in the future. Signer hereby authorizes and instructs any consumer reporting agency, financial institution and other persons or entities possessing information about Signer and/or Applicant to furnish WFFL with all such information in response to an inquiry from WFFL both now and at any time in the future.
Vendor/Supplier’s Certification: By submitting this application to Wells Fargo Financial Leasing, Inc., its subsidiary or affiliate (“WFFL”), Vendor, by and through the individual employee or representative of Vendor who is transmitting this application to WFFL, hereby represents and certifies to WFFL that: (1) all information contained in the above referenced credit application is true and correct to the best of Vendor’s knowledge, (2) in the event Vendor later discovers that any of the above information is not correct, Vendor will submit to WFFL a new application with the correct information, (3) Vendor is submitting the above credit application on behalf of the credit applicant named above (the “Applicant”) with the express permission, and at the express direction, of the Applicant for the purpose of obtaining credit from WFFL for commercial or agricultural (and not for personal, family or household) purposes, (4) the Applicant and each person named as a principal in the application, if any (each, a “Principal”) has expressly authorized Vendor and any potential funding source (such as WFFL) (a “Funding Source”) to obtain business and personal credit, financial and other information about the Applicant and each such Principal, including but not limited to, information from banks, consumer reporting agencies, credit bureaus and other information sources (each, a “Reporting Source”), and (5) the Applicant and each such Principal, if any, has expressly authorized Vendor and any Funding Source to instruct any and all Reporting Sources to furnish directly to such Funding Source all such information about the Applicant and each Principal.
The above is complete and accurate to the best of my abilities. (Required)	Yes