Printed Version

    Ownership Company Structure

    Current Financial Summary

    Bank(s)

    Trade References

    Insurance Information (Liability, Physical Damage, Loss Payee Required)

    Disclosure for all Applicants (Must provide an explanation to any Yes answers)

    By checking this box I/we, for the purpose of obtaining credit, the undersigned hereby authorizes Renegade Equipment, Sales, & Consulting, LLC, or any of its agents or assignees to check the credit and employment history of the applicant and owners. I do hereby certify that the above information is true and correct to the best of my knowledge. The undersigned further certifies and agrees that the acceptance by Renegade Equipment, Sales, & Consulting, LLC of the Credit Statement in no way obligates Renegade Equipment, Sales, & Consulting, LLC to extend credit or to arrange credit for the undersigned. Renegade Equipment, Sales, & Consulting, LLC may deny the undersigned credit or assistance in obtaining credit for any reason or for no reason. Please note credit information and reports will be shared with the equipment Renter.