Accuracy Transport

Back

CREDIT APPLICATION.

General Information

DATE OF APPLICATION:

BUSINESS NAME:

Address:

City: State: Zip Code:

Phone: Fax:

D/B/A:

FEDERAL TAX I.D.NUMBER:

TYPE OF BUSINESS: HOW LONG IN BUSINESS:

PRINCIPAL (name, title, address):

ACCOUNTS PAYABLE CONTACT NAME&PHONE:

PAYABLE E-MAIL ADDRESS:

CREDIT INFORMATION

ESTIMATED MAXIMUM CREDIT DESIRED PER MONTH:$

TRADE REFERENCES

TO EXPEDITE YOUR CREDIT APPLICATION, PLEASE ENSURE THAT ALL FIELDS ARE FILLED OUT COMPLETELY. PLEASE SUPPLY ACCOUNT NUMBERS IF THEY WILL BE REQUIRED TO CHECK YOUR REFERENCE

Name

Address

Fax Number

BANK REFERENCES

IMPERATIVE that you provide an account number to check your reference.
Name, address, acount, contact

SIGNATURE FOR PERMISSION TO CHECK YOUR REFERENCES: