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CONOR TRANSPORTATION INC.
Credit
Application
[Items
marked with * are REQUiRED]
Company
Information
*Company
Name:
*E-Mail
Address:
Billing
Information (Address, City, State/Province, Postal Code/Zip)
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*Phone:
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Fax:
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Accounts
Payable Contact/Ext.:
Name(s)
of Principal Owners or Officers |
Name:
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Title:
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Name:
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Title:
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Bank
Reference
Name:
Branch
or SWIFT Number:
Account Number:
Address
Information (Address, City, State/Province, Postal Code/Zip)
Contact:
Phone:
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Trade
References
Name:
Phone:
Contact:
Address
Information (Address, City, State/Province, Postal Code/Zip)
Name:
Phone:
Contact:
Address
Information (Address, City, State/Province, Postal Code/Zip)
Name:
Phone:
Contact:
Address
Information (Address, City, State/Province, Postal Code/Zip)
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I
understand that terms are Net 30 days, and a Finance Charge (19.8%
APR) will apply to all past due accounts. By submitting this form,
I hereby authorize all references to release credit information
regarding our company to Conor Transportation Inc., for the purpose
of this application. By submitting this form I also certify that
all information provided above is true and correct.
PLEASE
NOTE: Conor Transportation Inc. will call or request a fax
confirming your Credit Application request. NO attempt
will be made to release credit information from your references
until your company's intentions are confirmed.
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