Credit Application

Please fill out the form below and click on "Send Credit Application"

RSB Sales Person	:
Legal Business Name	:
Operating As	:
Street Address	:
Mailing Address	:
Telephone #	:
Fax #	:
Form of Org.	:	Corporaton Partnership Individual Other
Type of Business	:
Annual Sales Revenue	:
Number of Employees	:
Branch Offices	:
Related Companies	:
Company Principals	:
Accounts Payable	:
Traffic Mgr	:
MC#	:
Federal ID	:
Bonding Information	:
Monthly Credit Requested	:
P/O Required?	:	Yes No Other
If Other, please specify	:
Credit References - Banks: (Please provide Name, Address, Ph/Fax) 1.	:
2.	:
Transportation Companies: (Please provide Name, Address, Ph/Fax#) 1.	:
2.	:
3.	:
4.	:
Please send copy of recent annual financial statement and company brochure
TERMS: Invoices are due within 30 days from billing dates. Accounts past due may be assessed a service charges at 2 percent per month until the overdue amounts and service charges are paid in full. Credit, if granted, may be suspended at anytime without notice.
We hereby acknowledge the terms of our credit privledges with RSB LOGISTIC INC. and consent to the disclosure
of any information held by the references listed above. YES NO
Name	:
Email	:
Title	:
Date	:
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