Speedster Motorcars
Credit Application
Attn: Todd Bontrager
Phone: 727 540-9491
Fax: 727 540-9536
________________________________________________________________________________________________________________

Full Legal Business Name_______________________________________

Address_______________________________________________________

City/State/Zip__________________________________________________

Phone_________________________ Fax___________________________

Date Established_______________________________________________

Type  of Business______________________________________________

How many years in business? Or in this business?_________________

Principal______________________________________________________

Address_______________________________________________________

City/State/Zip__________________________________________________

Phone_________________________ Fax___________________________

Fed. Tax ID____________________________________________________

Ownership- Sole Owner___ Partner ____ Corporation___ Non-Profit___ 

Guarantor information

Full Legal Business Name_______________________________________

Address_______________________________________________________

City/State/Zip__________________________________________________

Phone________________________ Fax____________________________	

SS#___________________________________________________________

Banking References (if current account is less than 2 years old please provide prior bank reference)

Bank_____________________________	Phone______________________

Account #_________________________	Contact_____________________

Bank_____________________________	Phone______________________

Account #_________________________	Contact_____________________

Loans, Leases, Installment Debt

Name_____________________________Phone______________________

Account #_________________________	Contact_____________________

Name_____________________________Phone______________________

Account #_________________________	Contact_____________________

Trade References

Company__________________________Phone______________________

Account #_________________________	Contact_____________________

Company__________________________Phone______________________

Account #_________________________	Contact_____________________

Company__________________________Phone______________________

Account #_________________________	Contact_____________________

Type of Car

Z-Series Zephyr Coupe____________________	

Z-Series Zephyr Convertible________________

Classic Auburn___________________________

Referrer: http://decorides.com

Please Fill out and Fax to: 727-540-9536 or call and ask for Todd Bontranger to apply by phone.