Credit Application

Name

This field is for validation purposes and should be left unchanged.

Who are you

Please provide your name and contact details

Name*

First Last

Email*

Enter Email Confirm Email

Phone*

Line of Credit

CREDIT LINE REQUESTED*

Please enter a number from 1000 to 25000.

US DOLLARS

Please choose the line of credit that you are seeking. Approval is based on references and your credit report. You may not be awarded the line of credit that you are requesting, but receive a lesser amount based on your credit rating.

Business Information

BUSINESS NAME*

BUSINESS ADDRESS*

Street Address Address Line 2 City State ZIP Code

USE MAILING ADDRESS FOR BILLING*

Yes

BUSINESS TYPE*

Corporation

LLC

Partnership

Sole Proprietor

Government

Billing Address

BILLING ADDRESS

Street Address Address Line 2 City State ZIP Code

Business Contact

BUSINESS PHONE*

BUSINESS FAX

BUSINESS EMAIL*

Enter Email Confirm Email

Business Website*

If you do not have a website, please enter N/A

Business Details

YEAR BUSINESS STARTED*

ANNUAL SALES*

Full name of Corporate Members; Partners; or Proprietors (Principles)*

Name

Title

Click the "Circle +" shown to add additional rows.

Business References

We require at least three credit references to process this application

Established Commercial / Business Credit References*

Business Name

Phone

Account Number

Established Commercial / Business Credit References*

Business Name

Phone

Account Number

Established Commercial / Business Credit References*

Business Name

Phone

Account Number

BANKING INFORMATION

WHO DO YOU BANK WITH*

Name of Bank

Branch

Account Number

Account Contact

BANK PHONE*

FAX NUMBER

Sales Tax Status and FIN

STATE RESALE / EXEMPTION TAX STATUS*

Always Tax

Sometimes Tax

Never Tax

Exemption status requires that you also submit the Interstate Tax Exemption documentation to prove your status. A link will be provided once this form is submitted.

FEDERAL IDENTIFICATION NUMBER*

File Upload

This is your opportunity to provide additional information that may be in paper form.

File

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 3 MB.

Signature

TERMS OF SALE

SOUND TRUCK AND TRAILER REPAIR, INC’S TERMS OF SALE: NET 30 DAYS FROM DATE OF INVOICE. BOOKS ARE CLOSED ON THE LAST DAY OF THE MONTH. PAYMENT IS DELINQUENT AFTER 30 DAYS FROM DATE OF THE INVOICE. DELINQUENT ACCOUNTS ARE SUBJECT TO C.O.D. (CASH SALE) TERMS, COLLECTION, COLLECTION EXPENSES, AND REASONABLE ATTORNEY FEES. APPLICANT AUTHORIZES SOUND TRUCK AND TRAILER REPAIR, INC TO CONDUCT A CREDIT INVESTIGATION AND CONTACT ANY AND ALL REFERENCES AS PROVIDED ABOVE. IF ACCOUNT APPLICATION IS APPROVED AND COMMERCIAL/BUSINESS CREDIT PRIVILEGES ARE GRANTED, THE UNDERSIGNED HAS READ AND AGREED TO THE ABOVE TERMS OF SALE, AND WARRANTS THAT ALL INFORMATION PROVIDED IS TRUE AND ACCURATE. NET CASH IS OF INVOICE DATE OF CHARGE. 1.5% WILL BE CHARGED ON PAST DUE ACCOUNTS. CHARGE ACCOUNTS ARE DUE ON NET 1.5 FROM INVOICE DATE. PAST DUE ACCOUNTS WILL BE PLACED ON C.O.D.

Read Terms: Acknowledgement*

Agreed

Check box to acknowledge that you have read and understand the terms listed above.

Authority: Acknowledgement*

Agreed

Check box to acknowledge that you have the authority to apply for this line of credit for this business.

ELECTRONIC SIGNATURE*

First Last

By entering your name here and submitting, you are digitally signing this form and authorizing the forms review as intended.

Signature*

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