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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)

*Phone:
Fax:

Accounts Payable Contact/Ext.:

Name(s) of Principal Owners or Officers

Name:   Title:
Name: Title:

Bank Reference 

Name:  

Branch or SWIFT Number:

Account Number:

Address Information (Address, City, State/Province, Postal Code/Zip)

Contact:  

Phone:

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)

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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