New Customer Application

Step 1 of 7

14%

Bill To
Company Name (Legal Name)*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
CEO/Owner*
First Last
Point of Contact*
First Last
Phone*
Fax
Email*
Ship To
If different from billing information
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Point of Contact
First Last
Phone
Fax
Email

Company Information
Trade Style/DBA*
- Proprietorship
- Partnership
- Corporation
- Subsidiary
- Division
- LLC
Annual Company Sales*
Anticipated Monthly Purchases*
Do you hav e EDI and/or EFT payment capabilities?*
- Yes
- No
Date Established*
Date Format: MM slash DD slash YYYY
D&B Number
Federal ID Number*
Sales Tax or Value Added Tax ID Number*

Bank Information
Bank Name*
First
Account Number*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your Account Officer*
First Last
Phone*
Fax

First Trade Reference - Three Required
Company Name
First
Contact Person
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Fax

Second Trade Reference
Company Name
First
Contact Person
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Fax

Third Trade Reference
Company Name
First
Contact Person
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Fax

I authorize the references named herein, both financial institutions and trade references, to release any financial and credit information known to them to Cargo Repair LLC with the understanding that it will be used solely for credit purposes. Furthermore, if this credit application is accepted, I/We agree to pay for purchases in accordance with the terms and conditions set by Cargo Repair LLC.
Cargo Repair LLC (the Company) provides agreed goods and services in exchange for payment within terms. It is the Company’s normal policy to extend payment terms of 30 days from invoice date to qualified applicants. Payment is expected at the Company’s designated address (specified on the invoice) within 30 days of the invoice date. Thirty (30) day terms are upheld. Cash on Delivery (COD), Payment Prior to Shipment (PPS) or any other method of payment may be required pending receipt and review of a customer’s credit application, financials and references. Past due accounts will be subject to a 1.5% per month interest charge. Past due accounts will result in credit hold.It is understood and agreed that, once Cargo Repair LLC has approved the credit application, payment will be tendered according to the assigned credit terms. Cargo Repair LLC may take any action required in case of failure to make payment as agreed. This may include, but is not limited to, use of outside agencies or attorneys. Costs and fees incurred by outside service agencies or attorneys will be an additional liability on the part of the debtor organization.
Sole Proprietorships, Partnerships, Joint Ventures, Personally Held CorporationsI (WE) agree that the Sole Proprietorship, Partnership, Joint Venture, or Personally Held Corporation indicated below will pay all invoices in accordance with agreed terms. All signatories for this organization agree, in the event of the failure of the organization to pay invoices as rendered, to personally reimburse the Company for all liabilities incurred.
Company Name
First
Name
First Last
Title
Date
Date Format: MM slash DD slash YYYY

New Customer Application

Step 1 of 7

Bill To

Ship To

Company Information

Bank Information

First Trade Reference - Three Required

Second Trade Reference

Third Trade Reference