Credit Application -- STS Truck Equipment and Trailer Sales --


C R E D I T A P P L I C A T I O N

Company Information
Firm Name
Bill to Address 1
Bill to Address 2
County
City	State Zip
Phone
Fax
Business is:	Other:

Tax & Purchase Information
Will purchases from STS be Taxable? Yes No Indicate applicable state or local tax rate: Credit limit requested: Do you require a purchase order? Yes No

Name of Principal of Business
Name 1	Title:
Address
Name 2	Title:
Address

Financial Information
Type of Business
Approx. Net Worth	Yrly Sales Yrs in Business
Number of Employees	D&B Rating
Bank Name
Bank Address 1
Bank Address 2
Bank Phone	Contact Person

Trade References If not filled in completely, application cannot be processed.
Business Name
Phone	Fax
Address
Business Name
Phone	Fax
Address
Business Name
Phone	Fax
Address
Business Name
Phone	Fax
Address
Digital Signature
I agree to attest the financial responsibility, ability and willingness to pay our invoices in accordance with the terms and authorize investigation of all statements contained in this application concerning credit histories. I undersand the payment terms are specified by an invoice service charge of 1½% per month on all overdue balances (balances will include any prior unpaid service charges). I understand overdue accounts may be referred to an attorney for collection and if suit is commenced, I agree to pay reasonable attorney's fees. I also hereby certify that I am authorized to submit this form and that the information is true and correct. I further understand that a typed version of my name is being accepted as my original signature pursuant to the Federal Electronic Signature Act. I Agree I Disagree
Name
Title
Date