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John Deere Credit Application
I. Applying as: (check one)
Tax ID Number:  
(A) Individual (D) General Partnership (G) S-Corp
(B) Sole Proprietor  (E) Limited Partnership (H)C-Corp
(C) Municipality (F) Trust ( I )LLC
 
II. Full legal (LOCAL) address of Business {or (C) Municipality} (i.e. Billing Address):

  Street:
  City: County: Zip:
  Phone: State:
  Fax: Email Address:
           
III. IF you are applying as (A) an Individual OR (B) a Sole Proprietor, OR an Officer of a 
     Registered Organization, please complete the following:

  Full Legal Name First: Middle: Last:
  Social Security #: D.O.B.: Title:

Full Legal Address of your Principal Residence:

  Street:
  City: County: Zip:
  Phone: State:
  Fax: Email Address:

IV. IF you are applying as a Registered Organization such as (E) Limited Partnership, (G) an 
      S-Corp, (H) a C-Corp, or (I) a LLC, please complete the following:

  Full Legal Business Name:
  (DBA, if any):
  State in which the Business is Registered or Incorporated:
  Business Identification (Registration) Number**:
     **(NOT Tax ID Number)

V. IF you are applying as a (D) a General Partnership, OR (F) a Trust, please complete the following:

Full Legal Business Address of the Chief Executive Office (i.e. Company Headquarters, if different from Step II):

  Street:
  City: County: Zip:
  Phone: State:

VI. General Information and References (all applicants except Government agencies) 
     NOTE: <*> indicates required information:

<*> Annual Gross Sales: $ 

 Net Income: $ 

Years in Business: 

Bank Name: Acct#: Phone #:
Equip. Fin. Co.: Acct#: Phone #:
Equip. Fin. Co.: Acct#: Phone #:
Ever filed Bankruptcy? Yes  No Has a judgment ever been filed against you?   Yes  No

VII. Co-Applicant Information:

Name: Social Security #:
Address:
Phone: Email Address*:

Notice to Customer(s): Do not sign this credit agreement before you read it (pages 1 and 2). You are entitled to a copy of the credit agreement at the time you sign it. Applicant(s) represent that all information provided is complete and accurate.
Customer Authorization(s):
I (We) hereby grant FPC Financial, f.s.b., Deere Credit, Inc., or John Deere Construction Equipment Company (JDCEC) (all three collectively known as John Deere Credit) authorization to check with reporting agencies, credit references, and other sources in investigating the information I (we) have provided in this application. I (We) further authorize those reporting agencies, credit references, and other sources to provide a copy of my (our) financial statement(s), including, but not limited to, my (our) balance sheet(s), cash flow statement(s), and income statement(s). I (We) also grant John Deere Credit permission to obtain a credit report on me (us) for all legitimate purposes in connection with this transaction. Such purposes include assisting in making a credit decision, reviewing my (our) accounts, and assisting in taking collection activity. I (We) understand that this application may be used in obtaining credit approval for any John Deere Credit product (including, but not limited to) installment, lease or PowerPlan products. I (We) acknowledge that I (we) have read this application, understand its contents, and agree to its terms. I (We) understand that approved credit is for commercial or governmental use only. I (We) authorize John Deere Credit to share information with its affiliates, to disclose financial information about me (us) as described in this application, and further notices sent to me (us), and to me (us) information by facsimile transmission or other electronic means. I (We) also agree that any notices of disclosure can, at John Deere Credit's option, be provided electronically to the last email address that I (we) provided to John Deere Credit.
I (We) certify that I am (we are) authorized to sign on behalf of the applicant(s).
***This Credit Application consists of two (2) pages. Notice to Customer is continued on next page. 

Applicant's Name*:           Date*: 
Co-Applicant's Name*:      Date*: 
 
 

Disclaimer: "E-mail is not considered to be a completely secure medium for the transmission of sensitive information. Those who e-mail credit application information do so at their own risk."


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