Mullen Coach
Phone: 855-880-6124

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Credit Application

At Mullen Coach we specialize in providing credit and leasing services to the funeral industry, along with other select industires. If you have any questions or would like additional information please call (800) 548-4040. You may use this online form to securely submit your information to Mullen Coach. If you prefer to download and fax the form click here.

Legal company name DBA
Address City State Zip
Contact person Phone Yrs. In Business
Type of entity
Auto to be leased New Previously Owned
Year Model Serial Number

Officers/Owners (Those authorized to sign)

Name Title SS#
Home Address City State Zip Home Phone
Name Title SS#
Home Address City State Zip Home Phone

Company Bank References

Name of Bank Branch
How Long? Checking Acct.# Phone Contact Officer
Name of Bank Branch
How Long? Checking Acct.# Phone Contact Officer

Trade References

Name of Supplier Phone Contact
Name of Supplier Phone Contact

ACKNOWLEDGEMENT AND AUTHORIZATION


The undersigned verifies the accuracy of all the information contained in this application and authorizes any of the above references and credit reporting agency or other third party to release any personal or company information concerning the undersigned’s credit standing to Mullen Coach, LLC or its assignee. By entering your name in the electronic signature below, I am also agreeing to have read the following privacy practices.
Electronic Signature Date

Please read the privacy practices below and submit.

Dear Valued Customer: Our company respects your concern for privacy. Our goal is to respond to your inquiries, to provide better customer service, and to provide products, services and other promotional information that you request and that we believe may help meet your needs or be of interest to you. However, we recognize that we have an important responsibility to protect the privacy and security of the non-public personal information we collect from you. Therefore, we want you to understand our information sharing practices and for you to know that they are designed to ensure the confidentiality of your information.

Authorization By filling out this form you authorize us to share your non-public and personal information with affiliated and/or non-affiliated third parties. I may be better served and I may receive offers for other products and services that may be of value to me.

Nonaffiliated Click the box if you do NOT want us to share your personal non-public information with non-affiliated third parties except as permitted by law. (Note: If there are joint parties to your account, any party may complete this form, which will apply to all parties on the account. If you initial this, you may receive offers for other products and services that may be of value to you.)

Affiliated Click the box if you do NOT want us to share your personal non-public information with affiliated third parties except as permitted by law. (Note: If there are joint parties to your account, any party may complete this form, which will apply to all parties on the account. If you initial this, you may not receive offers for other products and services that may be of value to you.)

THE TYPE OF INFORMATION WE COLLECT
The type of information that we collect depends upon the product or service we are providing to you or that you are asking about. We collect information that you have provided to us on applications and other forms; information about your transactions with us, our affiliates, or others; and information that is provided to us by third parties including credit reporting agencies, individual referenced services public record data bases and other recognized providers of nonpublic personal information.

The information we collect may include identifying information such as your name, address, birth date, social security number, email address and other information on how to contact you; your credit worthiness, credit score and history; as well as transaction information such as account activity and loan terms. We may also collect financial information such as your income, assets and employment status; information about your spouse or dependents; and/or certain demographic information. If you apply for an insurance product, we may collect limited health information on your application.

HOW WE TREAT THE INFORMATION
Our company is committed to the security and confidentiality of your nonpublic personal information. We do not disclose, nor do we reserve the right to disclose, any nonpublic personal information about our customers or former customers to anyone, except as authorized by you or as otherwise permitted by law. In addition to reasonable physical, procedural and electronic security measure, our security practices include limiting access to this information to those employees and business associates with appropriate authority and for intended business purposes only. We explain the importance of protecting your nonpublic personal information to our employees and take appropriate measures to enforce employee responsibilities regarding our Privacy Policy.

We do not disclose health information for marketing purposes. We disclose health information to affiliates or nonaffiliated third parties only underwrite or administer your account or claim, or as otherwise permitted or required by law or court order. We require any third party who receives information about you from us to agree to keep that information confidential and to use the information only for the purposes for which it was disclosed.

DISCLOSURES TO AFFILIATED ENTITIES
We may share the information we collect, as listed above, with affiliated entities. You have a right to prevent the sharing of information, except for the sharing of information relating solely to your transactions with us (such as your payment history) or our experiences with you. If you do not want us to share this information with our affiliates, please initial on the appropriate line on the agreement form and return to us.

DISCLOSURES TO NON-AFFILIATED ENTITIES
We may share the information we collect, as listed above, nonaffiliated third parties for the purpose of offering products and services that may be of value to you. Organizations that may receive your information include, but are not limited to: financial institutions such as motor vehicle lenders or lessors; mortgage brokers and insurance agents; non-financial companies, such as: retailers, publishers and direct marketers; providers of aftermarket products such as Guaranteed Automobile Protection products, warranties and service contracts; and others such as trade associations and nonprofit organizations. In addition, we may disclose certain information to affiliates and nonaffiliated third parties, as applicable and as permitted or required by law or court order. We will disclose such information only with organizations that agree to treat if confidentially and to use it only for the purposes intended. If you do not want us to disclose information for these purposes, please initial the appropriate line on the agreement form and return it to us.

Typically, we retain personal information for a period of time after the end of a customer relationship. In some cases, we may be required by law or industry standard to retain certain information for a specified period of time. We maintain the same standards of privacy for all consumers and customers, both current and former.

A FINAL WORD
We are permitted by law to disclose information about you to third parties that perform marketing services on our behalf and/or to other financial institutions with which we have joint marketing agreements. We are not required to give you the opportunity to opt out such disclosures.

Because your trust and confidence in our company matters to us, we are committed to keeping your informed about our privacy practices and your rights. By using information, we are able to deliver products and services that meet your needs. Therefore, it may be necessary for us to periodically review and update our privacy practices in order to provide the best service. Although you will receive multiple copies of this notice over time, you only need to notify us once per account of your information sharing preference. If you have any questions regarding your rights or the contents of this notice, please call us. You may contact us at (800) 548-4040.


Proud to be Kansas City's dealer of this exclusive line of funeral and transportation vehicles

Mullen Coach has moved to a much larger facility to better serve our customers.
1102 S. Mill • Kansas City, KS 66105 • 855-880-6124 • Mailing Address: PO Box 15101 • Lenexa, KS 66285

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