Customer Credit Application

Form must be submitted by owner or officer of your company. All required fields are marked with '*'.
Please fill out the form below or you can click here for a PDF document which you can mail to us.
Account Information
Account Information Business Address
Date: 5/24/2013 Street Address*:
Account Name*: City*:
Also Known As: State*:
Sales Person*: Zip Code*:  
Tax ID*: Telephone*:  
Owner/CEO: Fax:  
Owner Email:   Email*:  
Website: Billing Address Same As Business Address
Contact Information
Accounting Dept Contact Information Accounts Payable Contact Information
Contact*: Contact*:
Telephone*:   Telephone*:  
Fax:   Fax:  
Email:   Email:  
Same as Accounting Dept Contact Info
Business References
Name Telephone Fax
Trade Reference 1*:    
Trade Reference 2*:    
Bank Reference 1*:    
Bank Reference 2*:    
Extra
Special Requirements to Process Invoices for Payments:
Terms of Payment/Statement
Logistics Plus, Inc. typical customer Term of Payment is Net 30 Days from date of invoice, provided the credit application is approved. Alternative terms may be offered if the application is incomplete or the applicant’s credit score does not meet Logistics Plus, Inc. standards. We reserve the right to charge customers finance charges of 1.5% per month, or the highest rate permitted by law, on any past due amounts. Additionally, any costs incurred for the collection of charges beyond the Terms of Payment, through litigation or independent collection resources are the sole responsibility of the customer, including reasonable attorney fees and Court costs. Should litigation be required with this account, filing will occur in the Court of Common Pleas of Erie County, Pennsylvania or in the United States District Court for the Western District of Pennsylvania and shall be subject to the Commonwealth of Pennsylvania Law.
I (We) understand and agree to the above stated Terms of Payment and I (We) authorize Logistics Plus, Inc. to verify and investigate all information provided on this credit application
Name Title Date
 
(ex:9/9/9999)
Please type the characters you see above in the box below.