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APPLICATION FOR CREDIT

Company: Type of Business:
Address: How long in business?
  Amount requested $
City: Contact Name:
State: Zip: Title:
Check preferred contact method:
Email: Other: 
Phone(area code): Fax: 
Ownership: Corporation  Partnership   Sole Owner  Other: 
Principal Name: Title:
TRADE REFERENCES:
Name: Address:
City: State: Zip1:
Phone:  
Name: Address:
City: State: Zip:
Telephone:  
BANK REFERENCES:
Name: Address:
City: State: Zip:
Phone: Acct#
Name: Address:
City: State: Zip:
Phone: Acct#
Type of Credit Agreement: Applicant agrees to pay any collections incurred to collect the account balance, including reasonable attorney's fees. Payment terms are net ten days upon receipt of invoice unless noted in "Type of Credit Agreement".
The undersigned as inducement to grant credit warrants that the information submitted is true and correct. By clicking on the "Submit" button, KLS Air Express Inc. is authorized to investigate the credit and bank references above.
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