1 800 956 7260 


​  National Route Sales

Confidential - Application 

Cut and paste the application fill it out and send to your broker             

  Please read and answer the questions. Place a check or circle where required.  You will not be considered, if you fail to completely answer every question. You may attach a    resume, but all these questions must be answered.                 

  First name: _______________________________________ Last name: ___________________________________  Middle Initial: _________

  Address: ___________________________________________, __________________________________________________________________,

  Do you own a home or a condo?    Y     N    Condo: ____ Home: ______    Do you rent?      Y       N

  Additional data needed - Please attach these to this application:

  Copy of proof of available funds, copy of driver’s license, proof of home address and a copy of your driving record.  

  Personal Financial Data: _________________ Personal net worth: $_________________

  Liquid Capitol: $_________________          Credit Score: _________________

  Total debit $_________________,  

  List liabilities ___________________ , ____________________, __________________, ___________________

  Sales price of business purchasing: $____________ Deposit on business: $___________ ( Amount to be held in Escrow)

  Most recent Businesses you've owned - State the type of business, the sales volume and years you have owned them:
2.                                                                                                                                                                                                                                                                                                    3,                                                                                                          

  Please add any additional information to the bottom of the page

  Home Telephone: ___________________________                Cell Phone number: ________________________

  E mail address: _____________________________               Marital Status: ______________________ 

  Driver’s license #: ___________________________               Number of children: _________________

  Special endorsement: ________________________               Date you can start: __________________

  Highest Annual Income: _____________________                Highest Education level: ______________

  Are you authorized to work unrestricted in the US?     Yes         No

  Have you ever been convicted of a felony? (Convictions may not disqualify an applicant):    Yes       No              

  If yes, explain: ___________________________________________________________________________________________________________________________                         ________________________________________________________________________________________________________________________________________


  Have you been told the essential functions of the business offering, have you viewed a copy of the position description listing the essential functions of the position?                    Yes          No

  Can you perform the essential functions of this business without special accommodation:     Yes           No

  QUALIFICATIONS: Please list any education or training you feel relates to the position applied for that would help you perform the work, such as schools, colleges,                employment or training.

  List the highest educational level, list all degrees, vocational or technical programs, and military service or                                                                                                                  training:_____________________________________________________________________________________                                                                                                              ____________________________________________________________________________________________

  SPECIAL SKILLS                                                                                                                                                                                                                                                                      List any special skills or experience that you feel would help you in the position that you are applying for (leadership, organizations/teams, etc.:                                                    ____________________________________________________________________________________________                                                                                                                ____________________________________________________________________________________________

  REFERENCES                                                                                                                                                                                                                                                                         Please list three professional references not related to you, with full name, address, phone number, and relationship.                                                                                                     1.________________________________________________________                                                                                                                                                                                     2.________________________________________________________                                                                                                                                                                                     3.________________________________________________________

  Business ownership history - List the 2 highest volume businesses you've owned (If it was employment list them):                                                                                                        ____________________________________________________________________________________________                                                                                                                ____________________________________________________________________________________________

  Reason for Selling or Leaving: _____________________________________________________________________________

  Starting Salary or profits: ____________________ Ending Salary or profits: _____________________

  I certify that the facts set forth in this Application for the right to buy and operate an absentee drop and hook line haul trucking business are true and complete to the              best of my knowledge.  I acknowledge and understand that once approved the company providing the management and  dispatching will assign ownership of the routes           I purchase.

  Date: _____/_____/_____ 

  Print Name: _______________________________________ Signature: __________________________________