Truck Application
1-800-377-3101
Truck Discount Mart specializes in Used Owner Operator style trucks we sell Kenworth trucks, Freightliner trucks, Volvo trucks, International trucks, Western Star trucks, Mack trucks, Sterling trucks - if we don't have what you are looking for give us a call we'll find it for you! We are the internet truck supermarket you've been hearing about! THE BEST DEAL IN TRUCKING!

Please complete the following online application and take a second to let us know where you originally heard about us...

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
Pager Number
FAX
E-mail Address
Date of Birth
Social Security Number
Drivers License Number
State
Expiration Date
HazMat Endorsement
Number of years OTR:
OTR Miles:
DUI or Felony / YR of Offense:
In the past 3 years Number of Speeding Tickets
Number of Moving Violations
Number of Accidents
Did you attend Truck Driving School
Where and how many weeks
Other License # and State
Marital Status
Wife or Significant Others Name
Are they employed
Their Monthly Income
# of Children at Home
Monthly Child Support
TOTAL MONTHLY EXPENSES
Do you Own or Rent
Monthly Rental/Mortgage Amount
Landlord/Mortgage Co Name
Their Address
Their Phone Number
Savings Bank Name
Account Number
Phone Number
Checking Bank Name
Account Number
Phone Number
Previous Address (last 5 years)
Previous Address (last 5 years)
REFERENCE #1 Name,Phone,Relationship
REFERENCE #2 Name,Phone,Relationship
Relative NOT Living with you,Phone,Relationship
Work History past 10 years Dates,Employer,Phone#
Dates,Employer,Phone#
Dates,Employer,Phone#
Dates,Employer,Phone#
Dates,Employer,Phone#
Dates,Employer,Phone#
Dates,Employer,Phone#
Dates,Employer,Phone#
Dates,Employer,Phone#
Dates,Employer,Phone#
******Where did you hear about us
Are you interested in a truck purchase?
Describe the truck you want.
What price do you want to pay?
Do you Have a Trade?
Describe your trade
Payoff on Trade
Where trade is financed?
Do you prefer a lease purchase?
This report is prepared under the Fair Credit Reporting Act (FCRA) guidelines.  I have the right to make a written request to Truck Discount Mart, Inc and the company Truck Discount Mart, Inc.  has contracted me with, to release the nature and substance of all information in its files on me at that time, including the source of information.  By submitting this application, I hereby consent to your obtaining the above information from DAC, and other services with the agreement that such information which Truck Discount Mart, Inc. has or obtains, including my business history with Truck Discount Mart, Inc. if accepted, may be supplied to other companies. I also agree to receive Truck Discount Mart, Inc's inventory updates.