Credit Application

Submit this application IF:

this equipment is for FARM or CONSUMER use, AND
this application amount PLUS all existing debt payable to Agricredit is LESS THAN $50,000

Applicant:

(1) affirms that the information provided in this application, including the reverse side if completed, is true and correct and given for the purpose of obtaining credit;
(2) understands that if credit is extended, Agricredit Acceptance LLC, it's agents, servicers, affiliates and assigns ("AAC Entities"), will rely on such information to secure the indebtedness;
(3) authorizes references to provide all relevant information to the AAC Entities;
(4) authorizes the AAC Entities to investigate and obtain reports concerning credit history; and
(5) authorizes the AAC Entities to release to, and share and exchange with :
(a) any other AAC Entities,
(b) any manufacturer of any equipment covered by this application, and
(c) any dealer who may sell or lease any of the equipment covered by this application or who may submit or originate this application, any information concerning Applicant or

Applicant's credit experience with the AAC Entities and their decision whether or not to extend any credit. Applicant waives any right to confidentiality that may exist with respect to the release, exchange or sharing of such information. The AAC Entities are authorized to retain any information obtained as part of the application process whether or not the requested credit is granted.

Agricredit Acceptance LLC Application for Credit
Tractor/equipment being considered
Name
Social Security Number
Date of Birth
Have you ever used AAC before?	No
Physical address (Street,City,State,Zip)
Mailing Address (Street,City,State,Zip)
County
Home phone
Cell phone
Marital status	Married Unmarried Separated
Years at current address
E-mail address
Name of nearest relative not living with you
Relationship
Relative"s address (Street,City,State,Zip)
Relative"s Phone
Type of business	Individual
Equipment use: (Farm, Home)
Physical address where equipment will be kept
Employer
Employer"s address (Street,City,State,Zip)
Years with employer
Annual gross income
Other income/amount
Do you farm? (Full Time/Part time)
Number of acres owned
Number of acres rented
Have you had any unsatisfied judgments against you in the past 7 years, had equipment repossessed in the past 7 years, or been declared bankrupt in the past 10 years?	No Yes
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