Corporate Application: Individual Application:
_________________________________________________ _______________________________________________________
Name of Corporation Signature of Individual
_______________________________ _______________ ______________
Signature of Officer/Title Date Date
In accordance with the Fair Credit Reporting Act, Public Law 9-508, I authorize Logistics Corporation to receive full information
as requested relating to our Credit and Bank experiences. The nature of this inquiry is to evaluate my request for an Open
Account (Net 30 Days) with a credit limit to be established commensurate with my needs and my credit and banking history.
CREDIT INVESTIGATION AUTHORIZATION
Bank Name ______________________________________ Checking Account Number ___________________________________
Street Address ____________________________________ City _________________________ State ________ Zip ____________
Individual Name ___________________________________ Phone _______________________ Fax _________________________
Email ______________________________________________________________________________________________________
BANK REFERENCE
Firm Name ________________________________ Applicant’s Name ________________________ Phone ___________________
Physical Address _______________________________ City _______________________________ State ____ Zip ____________
Mailing Address ________________________________ City _______________________________ State ____ Zip ____________
Type of Business____________________________ Name of Owners ___________________________________________________
Resale Tax Number _________________________________________ Location __________________________________________
Estimated Annual Sales ________________________________________________________________________________________
Former Business or Employment ______________________________ Years in Business __________________________________
Dun & Bradstreet Number ___________________________________ Monthly Credit Request $ ___________________________
Please check one:
Individual Partnership Corporation
APPLICATION FOR CREDIT
MAJOR TRADE REFERENCES
Company Name ___________________________________ Phone _______________________ Fax _________________________
Street Address ____________________________________ City _________________________ State ______Zip _______________
Email ______________________________________________________________________________________________________
Company Name ___________________________________ Phone _______________________ Fax _________________________
Street Address ____________________________________ City _________________________ State ______Zip _______________
Email ______________________________________________________________________________________________________
Company Name ___________________________________ Phone _______________________ Fax _________________________
Street Address ____________________________________ City _________________________ State ______Zip _______________
Email ______________________________________________________________________________________________________
*Signature Required for Terms Review
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