THE FREIGHT ESCAPE INC.
827 W. Thorndale Ave., Bensenville, IL 60106
(630)350-0555
FAX (630)350-0696
CREDIT APPLICATION
Company Name:_____________________________________________________________
Billing Address:______________________________________________________________
City:_________________________________ State:________ Zip Code:________________
Phone Number:__________________________ Fax Number:_________________________
Accounts Payable Contact/Ext.:_________________________________________________
NAME(S) OF PRINCIPAL OWNERS or OFFICERS
Name:_______________________________________ Title:_________________________
Name:_______________________________________ Title:_________________________
BANK REFERENCE: (Account from which payment will be made)
Name:_______________________________________ Account Number:_______________
Address:___________________________________________________________________
Contact:______________________________________ Phone Number:________________
TRADE REFERENCES
Name:_______________________________________ Phone Number:________________
Address:_____________________________________ Contact:______________________
Name:_______________________________________ Phone Number:________________
Address:_____________________________________ Contact:______________________
Name:_______________________________________ Phone Number:________________
Address:_____________________________________ Contact:______________________
I understand that terms are Net 30 days, and a Finance Charge (19.8% APR) will apply to all past due accounts. I hereby authorize all references to release credit information regarding our Company to The Freight Escape Inc., for application purposes. I also certify that all information provided above is true and correct.
Signature and Title:_______________________________________ Date:______________