Credit Application for a Business Account with Forklift Solutions, Inc.

Company Name: (required)
Contact Name: (required)
Phone: (required)
Fax:
E-mail: (required)
Address: (required)
City: (required)
State: (required)Zip: (required)

Ship to Address (if different)

Address:
City:
State: Zip: Date Business Established:
 Sole Proprietorship Partnership Corporation Other

Business and Credit Information

Bank Name:
Phone:
Bank Address:
City:
State: Zip: Account Number
Type of Account Savings Checking Other

Business / Trade References

Company Name:
Phone:
Fax:
E-mail:
Address:
City:
State: Zip: Type of Account:


Company Name:
Phone:
Fax:
E-mail:
Address:
City:
State: Zip: Type of Account:


Company Name:
Phone:
Fax:
E-mail:
Address:
City:
State: Zip: Type of Account:

Agreement

1. All invoices are to be paid 10 days from the date of the invoice.
2. Claims arising from invoices must be made within seven working days.
3. By submitting this application, you authorize Forklift Solutions, Inc. to make inquiries into the banking and business / trade references that you have supplied.

Signatures

Date:
Checking the box is considered a virtual Signature. You also acknowledge and agree that all the information above is correct to the best of your knowledge. (required)

Please enter the Letters and/or Numbers shown in the image below before hitting Submit