Thank you for taking the time to apply for the DB Kustom Trucks

program. The application is a two part process:

1. Apply to drive for Quality Carriers, North America ’s largest tank

truck company.

2. Apply for financing to purchase your own DB Kustom Truck along

with the guidance and help of two of the country’s premier Owner

Operators to insure your success.

Once the applications are completed, you will be contacted by a DB

Kustom Truck specialist to help walk you through the process and into

your Kustom ride as quickly as possible.

Please follow the two application guides in this packet to insure our

specialists have all the information they need to help get you into your

new Kustom truck as quickly as possible.

Thank you for your interest in our Kustom truck program and the entire

DB Kustom Trucks Team looks forward to working with you.

The DB Kustom Trucks Team.

Please go to the website address below to complete an application:

work4qc.com

Once at the website address:

Click on the button in the upper right hand

corner to access the online application.

Complete all information requested.

On the second page, please select the following from the drop

down boxes for the following questions:

Once the application is completed please submit.

The DB Kustom Trucks specialist will be in touch with you to

complete your application and to schedule you into our

training program.

Please complete the following documents:

Credit Application ("Individual Purchaser Statement")

Complete

Legible

No White Out

Original Signature (no stamped signature)

Crossroads Reference Sheet

Top Section Only (Personal References; Business not needed)

Complete

Legible

No White Out

Copy of your valid CDL

Front and back copies.

Enlarged

Clear Copy

Utility Bill

From within the past 30 days

Pay Stub/Settlement

From within the past 30 days

Return all five completed documents to:

Jessica Fernandez

Email: JFernand@QualityDistribution.com

Fax: (813) 569-1699

CROSSROADS EQUIPMENT LEASE & FINANCE, LLC INDIVIDUAL PURCHASER/LESSEE STATEMENT

:xaF relaeD :enohP relaeD :emaN relaeD

INDIVIDUAL/PARTNERSHIP INFORMATION: 1st :nwO :etarepO :yltnerruc uoy skcurt fo rebmuN .pxE pihsrenwO reyuB emiT

:htriB fo etaD :rebmuN ytiruceS laicoS :emaN lluF

rebmuN regaP rebmuN enohP emoH Cell Phone Number E-Mail Address

:piZ :etatS :ytnuoC :ytiC :sserddA gniliaM/lacisyhP tneserP

How Long at Present Address? Years: Months:

Rent Own Live with relatives Monthly Payment:

Previous Address (If less than 2 years)

:rebmuN enohP s’reyuB-oC :NSS s’reyuB-oC reyuB-oC

:piZ :etatS :ytnuoC :ytiC :sserddA lacisyhP tneserP

emocnI boj no emiT reyolpmE

NEAREST RELATIVES/PERSONAL REFERENCES NOT LIVING WITH YOU: Name

enohP piZ etatS ytiC sserddA

CORPORATION/LEGAL ENTITY INFORMATION (If Applicable) Exact Legal Name of Corporation/Legal Entity: Inc. LLC Other Federal ID#

Year of Organization

rebmuN ytiruceS laicoS reciffO lapicnirP

Title % Owned US DOT rebmuN CM rebmuN

CURRENT EMPLOYMENT INFORMATION Total Years of Driving Experience Years as revirD ynapmoC sa sraeY rotarepO renwO

:enohP :etatS :ytiC :emaN

emocnI shtnoM reyolpmE tnerruC ta sraeY tcatnoC

Other Annual Income rehtO rotarepO renwO revirD ynapmoC Amount ecruoS

FUTURE EMPLOYMENT rebmuN enohP etatS/ytiC emaN

diaP euneveR ylhtnoM seliM ylhtnoM tcatnoC/mile % of Gross

etatS #LD laicremmoC deluaH eb ot stcudorP

PREVIOUS EMPLOYERS ?gnoL woH tcatnoC rebmuN enohP etatS ytiC emaN

?gnoL woH tcatnoC rebmuN enohP etatS ytiC emaN

?gnoL woH tcatnoC rebmuN enohP etatS ytiC emaN

Salesperson’s Name:

LESSEE STATEMENT Trucks/Trailers Owned Description of Collateral

Lending Institution City/State Phone # Account #

Real Estate Lending Institution City/State Phone # Account #

Autos Owned Lending Institution City/State Phone # Account #

Bank Account Type Institution City/State Phone # Account #

Authorization to Release Credit InformationThe undersigned certifies that: (a) all of the information contained herein or provided in connection with this Application is true and correct and accurately describes the financial condition of the Customer(s) as of the date hereof; and (b) I will notify Crossroads Equipment Lease & Finance LLC, its successors and assigns ("Creditor") if I become aware of any material change in the financial condition of the Customer(s). I hereby authorize Creditor and/or Dealer to make inquiry into, to request, and to receive any information concerning my financial condition, including, but not limited to, obtaining a credit report and contacting any current or former creditors of Customer(s) to verify any information contained herein or received in connection with this Application, which Creditor and/or Dealer deems relevant to the possible extension of credit to Customer(s) (“Information”). I also grant any such creditors permission to release Information to Creditor and/or Dealer. I authorize Creditor to disclose Information to any affiliate, assigns or agent. I authorize Creditor to file a UCC financing statement. I have applied for a loan or extension of credit from Creditor and I intend to use the purchased Equipment primarily for business or commercial purposes, and not for personal, family, household or agricultural purposes. The foregoing provision shall remain in effect until Customer pays

Creditor in full (if Creditor decides to grant credit to Customer(s)).

Applicant Signature: Title (if applicable): Date:

Co-Applicant: Title (if applicable): Date:

Type of Application: Business Individual Used New Retrofit

V160.12102012-CJR

Buyer/Borrower/Lessee Name and Address Creditor/Lessor Name and Address

Crossroads Equipment Lease & Finance, LLC

9121 Haven Avenue, Suite 270

Rancho Cucamonga, CA 91730

Account Number:

Date:

PERSONAL REFERENCES

Reference 1

NAME: RELATIONSHIP Verified:

ADDRESS: CITY: BY:

STATE: ZIP: PHONE EMAIL: DATE:

Reference 2

NAME: RELATIONSHIP Verified:

ADDRESS: CITY: BY:

STATE: ZIP: PHONE EMAIL: DATE:

Reference 3

NAME: RELATIONSHIP Verified:

ADDRESS: CITY: BY:

STATE: ZIP: PHONE EMAIL: DATE:

Reference 4

NAME: RELATIONSHIP Verified:

ADDRESS: CITY: BY:

STATE: ZIP: PHONE EMAIL: DATE:

Business References

Trade References Bank References

Name of Company:___________________________________________________

Name of Contact:_____________________________________________________

Company Address:____________________________________________________

Telephone Number:___________________________________________________

Account Number____________________________________________________

Name of Company:______________________________________________________

Name of Contact:________________________________________________________

Company Address:______________________________________________________

Telephone Number:______________________________________________________

Account Number________________________________________________________

Name of Company:___________________________________________________

Name of Contact:_____________________________________________________

Company Address:____________________________________________________

Telephone Number:___________________________________________________

Account Number______________________________________________________

Name of Company:______________________________________________________

Name of Contact:________________________________________________________

Company Address:______________________________________________________

Telephone Number:______________________________________________________

Account Number________________________________________________________

Name of Company:___________________________________________________

Name of Contact:_____________________________________________________

Company Address:____________________________________________________

Telephone Number:___________________________________________________

Account Number_____________________________________________________

Name of Company:______________________________________________________

Name of Contact:________________________________________________________

Company Address:______________________________________________________

Telephone Number:______________________________________________________

Account Number________________________________________________________