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Credit Application

1&1 Transportation Inc

CREDIT APPLICATION FOR A BUSINESS ACCOUNT

BUSINESS CONTACT INFORMATION

Title Date business commenced
Company name Sole proprietorship
Partnership
Corporation
Other
Phone | Fax
Registered company address
E-mail
City, State ZIP Code

BUSINESS AND CREDIT INFORMATION

City, State ZIP Code Bank name:
How long at current address? Primary business address City, State ZIP Code:
Phone: Phone:
Fax: Account number:
E-mail: Type of account: Savings Checking Other

BUSINESS/TRADE REFERENCES

Company name Phone:
Address Fax:
City, State ZIP Code E-mail:
Type of account Savings Checking Other Other:
Company name Phone:
Address Fax:
City, State ZIP Code E-mail:
Type of account Savings Checking Other Other:
Company name Phone:
Address Fax:
City, State ZIP Code E-mail:
Type of account Savings Checking Other Other:

BILLING INFORMATION

Company Name Address
Name City
Phone State
E-mail ZIP

AGREEMENT

  1. All invoices are to be paid 14 days from the date of the invoice.
  2. Claims arising from invoices must be made within seven working days.
  3. By submitting this application, you authorize 1&1 Transportation Inc to make inquiries into the banking and business/trade references that you have supplied.

SIGNATURES

Signature Signature:
Name and Title Name and Title:
Date Date:
  
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