Brasher's Idaho Auto Auction, Inc
Attention: Loan Servicing
Boise, ID 83171
PHONE: (208) 345-7345
FAX: (208) 395-3148
28 Day to Pay Agreement Loan Application
Date of Application: ________________
Business/Dealership Name: ___________________________________________________________
Street Address: _____________________________________________________________________
City/State/Zip: _____________________________________________________________________
Mailling Address: ___________________________________________________________________
City/State/Zip: _____________________________________________________________________
Business Phone: ___________________ Mobil Phone: ________________ Fax: ________________
Type of Dealer: New Car: ______ Used Car: _______ Wholesale: ________
Date Dealersip Established: _____________________________
Dealer License #: _____________________________________
Federal Tax #: ________________________________________
State Resale Tax#: ____________________________________
Average number of vehicels purhased monthly at all auctions: _____________________________
Average purchase price per vehicle: _________________
Dealership is a: Proprietorship _______ Partnership ________ Corporation _________
Brasher's Idaho Auto Auction, Inc
Attention: Loan Servicing
Boise, ID 83171
PHONE: (208) 345-7345
FAX: (208) 395-3148
28 Day to Pay Agreement List of Owners/Partners
Dealership is a: Proprietorship _______ Partnership ________ Corporation _________
Name: ______________________________ Residence Phone: ___________________________
Address: ___________________________________ Social Security Number: ____ - ____ - ____
City: ___________________________________ Date of Birth: ___________________
State: _______________ Zip: ____________ Signature: ________________________________
Name: ______________________________ Residence Phone: ___________________________
Address: ___________________________________ Social Security Number: ____ - ____ - ____
City: ___________________________________ Date of Birth: ___________________
State: _______________ Zip: ____________ Signature: ________________________________
Name: ______________________________ Residence Phone: ___________________________
Address: ___________________________________ Social Security Number: ____ - ____ - ____
City: ___________________________________ Date of Birth: ___________________
State: _______________ Zip: ____________ Signature: ________________________________
Credit Release
Right to Request Specific Reasons: If your application for business credit is denied, you have the right to a written
statement of the specific reasons for denial. To obtain the statement, please contact us at the following address
within 60 days of the date you are notified of denial.
Brasher's Idaho Auto Auction, Inc.
Attention: Loan Servicing
P.O. Box 170342
Boise, ID 83171
Reporting Information to credit bureaus: We may report information about your account to credit bureaus. Late
payments, missed payments or other defaults on your account may be reflected in your credit report.
Applicant's Statement: By signing below, I certify that the information provided on and within this form, including
financial statements, is complete and correct and that I am authorized to execute this form on behalf of the Applicant.
I authorize Brasher's Idaho Auto Auction, Inc. (Lender) to obtain balance and payoff information on all accounts
requiring pay off as a condition of approving this application. I understand that Lender may check my credit records
and statements made by me. I give permission to all my creditors to give Lender any information it needs to make
credit granting decisions. I further authorize Lender to provide credit reporting agencies and other creditors
information relating to any credit Lender might grant to Applicant. I agree to promptly notify Lender of any material
changes that would affect the accuracy of the statements. All information is, as of this date, correct unless otherwise
stated. I authorize Lender to cause such UCC Financing statements to be filed in such form and in jurisdiction and
encumbering such assets as Lender or its counsel deem appropriate in their sole and absolute discretion.
Authorization to obtain Credit Report: By signing below, I authorize Brasher's Idaho Auto Auction, Inc. (Lender) to
obtain a copy of my credit report in connection with this application for credit, and any modifications, renewals, or
extensions of such credit. I acknowledge that Lender shall use the credit report in connection with a credit transaction
involving myself, whether or not I am the obligor, guarantor, or principal officer of the applicant, and that Lender has
a legitimate business need for the information. I acknowledge that this authorization is continuing in nature, and that
Lender may obtain updated or additional credit reports at any time in connection with renewal, extension or other
modification of any loan or other credit accommodation between Lender and myself, whether or not I am the obligor,
guarantor, or principal officer of the Applicant. I further direct the credit reporting agency to which Lender delivers a
copy of this authorization to furnish a credit report to Lender.
By signing below, I declare that I have read and understand the statements above.
____________________________
(signature)
______________________________
(printed name)
__________________
(date)
____________________________
(signature)
______________________________
(printed name)
__________________
(date)
____________________________
(signature)
______________________________
(printed name)
__________________
(date)
AA Subscribing Customer:
Address:
City:
St/Prov:
Postal Code:
Phone:
Fax:
Bank Reference Letter
AuctionACCESS® Dealership ID: ______________________
Dealership Name: ________________________________ Owner/Officer Name:
Bank Name: _____________________________________ Account #:
Bank Address: ___________________________________ ABA#:
Bank City: _________________________________ State/Province: ______ Country: _______ Postal Code:
Bank Reference Phone:
Bank Reference Fax:
Attention Credit Department or Officer:
The aforementioned Dealership has listed your bank as its principal banking reference.
AutoTec, LLC has compiled and maintains a national database, AuctionACCESS®, which contains information on licensed new and used car
dealers for use by its automobile industry customers. Since the automobile auctions frequently guarantee dealer checks for cars bought at their
auctions, they require that all dealers who do business with the auctions establish their financial responsibility.
We would be grateful if you would check mark below your estimate of this account. This information will be incorporated into the
AuctionACCESS® database; otherwise, this information will be kept strictly confidential and will be used only for our purposes and the purposes
of our Subscribing Customers. Please return this completed letter directly to the above address.
Dealership has been banking with your bank since: _______________________
 Checking
 Savings
Type(s) of accounts held:
The Customer is:
 Floor Plan
 ZBA
 Sweep
 Regular Account
 Special Account
 Loan Account
Account is:
 Controlled Disbursement
 Satisfactory
 Unsatisfactory
 Closed
Open Date:
Closed Date:
 A valued customer with a good reputation and financial responsibility
 Honest and reliable, but limited capital resources
 Unknown to us
 A new customer – our experience is limited
 Negative response
Average Balances for six months are:  Nominal
 Small
 Moderate
 Negative Balance
 Medium
 Large
 3 figures
 4 figures
 5 figures
 6 figures
 7 figures
Insufficient Checks or Drafts:
How Many?
 Does not issue
Overdrafts:
How Many?
 Does not issue
Maximum Credit recently extended:
$____________________________Secured
Do you floor plan this Customer?
 Yes
 No
Floor Plan Line New/Used: $________________
Do you accept their Drafts?  Yes  No
$____________________________Unsecured
Floor Plan Outstanding New/Used:
$________________
Are all Drafts picked up within 48 hours?  Yes  No
Physical Address of bank for sight Draft: __________________________________________________________________________
Remarks: ____________________________________________________________________________________________________
____________________________________________________________________________________________________________
Signature of Bank Official: ____________________________________
Title: _______________________________________
Print Name: ________________________________________________
Date: ________________ Phone: ________________
Thank you for your assistance.
BRL Form (Rev 04/07/2010)
Copyright © 2003-2010 AutoTec, LLC. All rights reserved.