Auction Funding Application

Business Information

Name of Auction *

Tax I.D. Number *

Legal (if different) *

Date Established *

Primary Address *

Primary Address

City

State/Province

Zip/Postal

Country

Do you have a secondary address? *

Yes

No

Secondary Address (if applicable)

City

State/Province

Zip/Postal

Country

Phone *

Fax *

Email *

Bank References

Name of Bank *

Name of Contact *

Address *

Address

City

State/Province

Zip/Postal

Country

Company Principals Responible for Business Transactions

Name/Title *

% Ownership *

Home Address *

Home Address

City

State/Province

Zip/Postal

Country

Phone *

Social Security # *

End Section

Phone *

Checking Account Number *

Auction Structure *

National Independent Auto Auction Association Member? *

Yes

No

Owned or Leased? *

Owned

Leased

Landlord Name *

Landlord Phone Number *

Auction Web Address *

Your email address *

Average # of cars running weekly *

Cars with model years averaging (i.e. 1995, 1996, etc) *

Average selling price range of vehicles *

# of full time employees *

# of part time employees *

Name of Floor Plan Company *

Address *

Address

City

State/Province

Zip/Postal

Country

Contact Name *

Phone Number *

Number of Financed Units *

End Section

Business Information

Bank References

Company Principals Responible for Business Transactions

General Business Information

Auction Profile

Auction Floor Plan Source(s)