Atlas Marine - Credit Application

Credit Application

Company Name:

Fed ID# / SSN:

Billing Address (line 1):

Since:

Type of Business:

Duns #:

Transportation Co. DOT #:

Phone #:

Bond Info:

Fax #:

Website:

Corporation Partnership Sole Proprieter Individual

Principals Full Name, Address, and Position:

Credit Level Requested:

Bank References

Bank Name:

Phone #:

Address (line 1):

Address (line 2):

Account #:

Trade References

Firm Name:

Phone #:

Address (line 1):

Address (line 2):

Firm Name:

Phone #:

Address (line 1):

Address (line 2):

Firm Name:

Phone #:

Address (line 1):

Address (line 2):

By completion and utilization of Services, you are aware that federal rules and regulations require payment of freight bills within 15 days of presentation as well as the following terms.

Our terms are net 30 and discounts may be cancelled on all bills which exceed 45 days.
Interest may be charged at the rate of 1/5% per month on any bills which exceeds 30 days.
Reserves the right to lien freight pending payment in full.
Any collection costs including court fees and attorney fees will be added to the invoice.
When account balance exceeds approved credit limits, all subsequent shipments will be driver collect and due at time of pickup or delivery of freight.

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Secured Form.

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Applicant Name:

Title:

Date:

APPLICANT AGREES TO ALL TERMS AND CONDITIONS ABOVE