Parts and Service Credit Application

Cash/COD Customer Account

Today’s Date

Name (Company or Personal)(Required)

E-Mail(Required)

Location(Required)

Address

Billing Address City State / Province / Region ZIP / Postal Code

Address

Shipping Address City State / Province / Region ZIP / Postal Code

Phone

Fax

OPTIONAL Tax Exempt Status (please check one if applicable)

Resale

I.C.C.

Farming

Manufacturing

Fishing Vessel

Shipped Out of State

Must provide proof of Tax Exempt Status

Open/Charge Customer Account

Today’s Date

Credit Line Requested: $(Required)

Company Name(Required)

TAX ID #

Location(Required)

Company Phone(Required)

Company Fax

Accounts Payable Contact

Accounts Payable Phone

Accounts Payable E-Mail

Company E-Mail

Address

Shipping Address City State / Province / Region ZIP / Postal Code

Address

Billing Address City State / Province / Region ZIP / Postal Code

Type of Business(Required)

Proprietorship

Partnership

LLC

Corporation

How Long In Business?

Does Your Company Require A PO Number?

Yes

Indicate(Required)

ICC#

Reseller Permit #

(Attach Copy of Tax Exemption)

Max. file size: 30 MB.

PARTNERS/OFFICERS/OWNERS

POSITION

HOME ADDRESS & PHONE

SOCIAL SEC#

Contact Person(Required)

Phone(Required)

COMPANY TRADE REFERENCES

(Financial Institutions are NOT Trade References)

Company

Address

Phone

Fax

Account Number

Company

Address

Phone

Fax

Account Number

IF INDIVIDUAL: NEAREST RELATIVE NOT LIVING WITH YOU:

Name

Address

Phone

ratio(Required)

PLEASE READ: THE UNDERSIGNED HEREBY CERTIFIES THE CORRECTNESS OF THE ABOVE INFORMATION, WHICH IS HEREBY GIVEN TO MOTOR TRUCKS, INC., FOR ITS USE INCONSIDERING CREDIT ACCOMMODATIONS REQUESTED; AGREES PAYMENT OF ANY CREDIT PURCHASE BY THE UNDERSIGNED, HIS AGENT, OR EMPLOYEE, SHALL BE GOVERNED BY WASHINGTON LAW; AGREES TO PAY FOR ALL GOODS AND SERVICES SO FURNISH BY THE 10 TH OF THE MONTH FOLLOWING PURCHASE, ACCORDING TO MOTOR TRUCKS, INC’S INVOICE TERMS; AGREES TO PAY A FINANCE CHARGE OF ONE AND ONE HALF PERCENT (1.5%) PER MONTH, ON ANY ACCOUNT BALANCE UNPAID 30 DAYS AFTER STATEMENT DATE; AGREES TO PAY ALL ATTORNEY FEES; COLLECTION AGENCY COSTS, AND ANY OTHER COST INCURRED BY MOTOT TRUCKS, INC. TO ENFORCE PAYMENT; AGREES THAT VENUE AND JURISDICTION TO ENFORCE PAYMENT WILL BE IN SKAGIT COUNTY, WASHINGTON, AND, WITH REGARD TO DISTRICT OR SMALL CLAIMS MATTER, WILL BE IN THE DIVISION OF SKAGIT COUNTY DISTRICT COURT. AGREES TO GIVE PRIOR NOTICE IN WRITING TO THE SALE OR TRANSFER OF ALL OR SUBSTANTIALLY ALL OF THE STOCK OR ASSETS OF OUR BUSINESS; IF WE FAIL TO DO SO, THEN WE SHALL REMAIN FULLY LIABLE FOR ANY UNPAID MERCHANDISE RECEIVED BY THE BUYER OR TRANSFEREE OF THE BUSINESS.

Signature(Required)

TITLE

THE UNDERSIGNED ISA PRINCIPAL OF THE APPLICANT BUSINESS, AND HEREBY PERSONALLY GUARANTEES ALL DEBT AND LIABILITY OF THE APPLICANT TO MOTOR TRUCKS INC., WHETHER NOW OWING OR HEREAFTER INCURRED. IT IS ACKNOWLEDGED THAT CREDIT WOULD NOT BE EXTENDED TO THE APPLICANT WITHOUT MY PERSONAL GUARANTEE.

Signature(Required)

Apply For Credit

Please choose the account type you would like to open

Cash/COD Customer Account

Open/Charge Customer Account

COMPANY TRADE REFERENCES

(Financial Institutions are NOT Trade References)

IF INDIVIDUAL: NEAREST RELATIVE NOT LIVING WITH YOU:

THE UNDERSIGNED ISA PRINCIPAL OF THE APPLICANT BUSINESS, AND HEREBY PERSONALLY GUARANTEES ALL DEBT AND LIABILITY OF THE APPLICANT TO MOTOR TRUCKS INC., WHETHER NOW OWING OR HEREAFTER INCURRED. IT IS ACKNOWLEDGED THAT CREDIT WOULD NOT BE EXTENDED TO THE APPLICANT WITHOUT MY PERSONAL GUARANTEE.

YOU ARE HERBY AUTHORIZED TO CONTACT AND OR ALL OF THE ABOVE REFERENCES REGARDING CREDIT

Links

OUR SERVICES

NEW TRUCKS

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