Credit application

CLIENT INFORMATION

Company Name: *

Address: *

City: *

Country: *

Region: *

Postal Code: *

Tel: *

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xxx-xxxx

Fax:

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xxx-xxxx

Billing contact: *

Billing email: *

Billing address (if different)

Name:

Address:

City:

Country:

Region:

Postal Code:

Tel:

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xxx-xxxx

Fax:

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xxx-xxxx

Company information

Type of enterprise: *

Number of years in business:*

Amount of credit requested: *

IATA Cass member account #:

Reffered by:

(America Cargo GSA agent name)

Bank Information

Account No.: *

Financial Institute: *

Address:

Contact:

City:

Country:

Region:

Postal Code:

Tel:

-

Fax:

-

Credit reference

Is Payable by Credit Card: *

Yes

If No, please provide requested information below.

Company *

Contact *

Phone *

Email *

One airline reference

Credit agreement

Our credit terms are Net 30 days from date of invoice. All over-due accounts will be subject to interests of 1.5% per month. Failure to comply with these terms can result in your credit privilege being suspended or revoked, and your account being placed on COD terms without further notification. Please remit on time. Thank you.

I agree the terms and conditions. *

Fill By: *

Phone or Email: *

Credit application

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