New Customer Credit Application Form

Required!
Required!
Required!

Payables:

Trade References: (Minimum of 3 are required, 2 must be carriers)

1.

2.

3.

4.

5.

Special Billing Information:

Yes No
Yes No
Yes No

THIS IS NOT A PERSONAL GUARANTEE:

I hereby represent that I am authorized to submit this application on behalf of the customer named above, and that the information provided is for the purpose of obtaining credit and is warranted to be true. I/we herby authorize Berry and Smith Trucking Ltd. to investigate the references listed pertaining to my/our credit and financial responsibility. It is agreed and understood that all necessary collection, legal expenses and interest may be charged to debtor in the event of default. I/we further represent that the customer applying for credit has the financial ability and willingness to pay all invoices with established terms.