Credit Application

    * Required field
    Business Contact Information

    Legal Name of Company:

    DBA Name:

    Name *

    Phone *

    Fax:

    Email *

    Registered Company Address:

    Address:

    City:

    State:

    Zip Code:

    Year Company Started:

    Referred By (BT Employee Name);

    Fein #

    # Employees:

    Trailer Fleet Size:

    Tax Exempt:

    YesNo

    Type of Business:

    Sole ProprietorshipPartnershipCorporation

    If so please provide sales tax exemption form with credit application otherwise will be charged tax

    Business and Credit Information

    Ins. Agency:

    Contact:

    Phone #

    Fax #

    US DOT #

    Bank Name:

    Bank Address:

    Phone #

    City:

    State:

    Zip Code:

    Type of Account

    SavingsCheckingOther

    Account #

    Business/Trade References

    [Reference #1] Company Name:

    Address:

    City:

    State:

    Zip Code:

    Phone:

    Fax:

    Email:

    Type of Account:

    [Reference #2] Company Name:

    Address:

    City:

    State:

    Zip Code:

    Phone:

    Fax:

    Email:

    Type of Account:

    [Reference #3] Company Name:

    Address:

    City:

    State:

    Zip Code:

    Phone:

    Fax:

    Email:

    Types of Account:

    Desired Services/Products

    Please enter the types of services you will need, include the number of trailer(s), type of trailer(s), and duration.

    Agreement

    All Invoices are to be paid 10 days from the date of the Invoice.

    Claims arising from invoices must be made within seven (7) working days.

    By Submitting this application, you authorize Boston Trailer, LLC to make inquiries in to the banking and business/trade references that you have supplied

    Signatures

    Title:

    Signature *

    Date *

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