Credit Application

To establish a permanent line of credit, we ask an officer of the company to complete the following:

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Legal Business Name*
Physical Address*
Street Address Address Line 2 City State ZIP Code
Billing Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Website*
Owner Name*
First Last
President Name*
First Last
A/P Name*
First Last
A/P Phone*
A/P Email*
Do you require any special requirements on your invoice?*
- Yes
- No
Please list the special requirements
Do you require the bill of lading to accompany the invoice?*
- Yes
- No
Do you offer ACH as a form of payment?*
- Yes
- No
Email invoices to:*
Trade References
Either upload or complete Trade References
Upload Trade References
Drop files here or
Trade Reference #1
Company
Address
Street Address Address Line 2 City State ZIP Code
Phone
Fax
Email
Trade Reference #2
Company
Address
Street Address Address Line 2 City State ZIP Code
Phone
Fax
Email
Trade Reference #3
Company
Address
Street Address Address Line 2 City State ZIP Code
Phone
Fax
Email
You shall pay all charges quoted by A.M. Transport Services, Inc. We require payment of all charges within 15 days from the due date of receipt. In addition, both the undersigned individual and the above named owner(s) of the business shall be personally liable for all obligations under this line of credit and as such, personally guarantee these obligations. In order to meet the time restraints of the transportation business, and at your request, you agree that a facsimile copy of all documents and signatures, including this line of credit document, shall be deemed an original signature and document and legally binding on the business and individuals obligated hereby.

You hereby agree to abide by the foregoing terms, that the above information is true and complete and you acknowledge receipt of a copy of this application and agreement. You authorize us to check your credit history and to answer questions about your credit experience with us.

NOTE: THIS MUST BE SIGNED BY AN OFFICER OF THE COMPANY
Will you be signing as an officer of the company?*
- Yes
- No
Signature*
Name*
Title*
Date*
ONLY AN OFFICER OF THE COMPANY CAN SUBMIT THIS FORM. IF YOU ARE AN OFFICER OF THE COMPANY PLEASE CHANGE YOUR ANSWER ABOVE

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Trade References

Trade Reference #1

Trade Reference #2

Trade Reference #3

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