Credit Application

Credit Application

 

Customer warrants that the following information is accurate and complete:

Name of Customer (Legal Name)
Name of Customer (Legal Name)
First
Last
Mailing Address
Mailing Address
City
State/Province
Zip/Postal
Shipping Address
Shipping Address
City
State/Province
Zip/Postal

Maximum file size: 65.01MB

Please check one:
Sales Tax Exemption: Customer will be charged the applicable sales tax on all purchases unless Customer submits a valid resale certificate or other proof of exemption on this form.
Has this business or any principals ever been involved in bankruptcy or any other insolvency proceedings?

Maximum file size: 65.01MB

Please check box if a reference sheet is attached and sign Term and Conditions.

Principals

Name of Principal
Name of Principal
First
Last
Address
Address
City
State/Province
Zip/Postal
Name of Principal
Name of Principal
First
Last
Address
Address
City
State/Province
Zip/Postal
Name of Principal
Name of Principal
First
Last
Address
Address
City
State/Province
Zip/Postal
Name of Principal
Name of Principal
First
Last
Address
Address
City
State/Province
Zip/Postal

Banking

Important: Fax number and area code will accelerate application processing.

Section

Trade References

Important: Fax numbers and area codes will accelerate application processing.

Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal
Name
Name
First
Last
Address
Address
City
State/Province
Zip/Postal

Terms and Conditions

For the purpose of establishing a line of credit with Stutsman Logistics, Inc., I certify that all of the information on this form and all other information now or hereafter submitted in connection with this request for credit, including any and all financial statements, is correct. I authorize them to obtain credit information from my bank and any other available references. Payment terms are net 30 and I agree to pay a late charge of 1.5% per month or the highest legal rate, whichever is less if not paid within the terms. I also agree to pay all costs of collection, including reasonable attorney fees incurred by or on behalf of Stutsman Logistics. Stutsman Logistics, Inc. reserves the right to deny or alter credit terms at any time.