Application Form JA

Business Contact Info

Credit Application for Business Account
Company Name*
Phone Number*

Area CodePhone Number
Fax Number

Area CodePhone Number
E-mail*

Date Business Commenced
Year
Industry of Business

ManufacturingWholesalerDistributorSupplierOther
Type of Business
Company Type*

Sole ProprietorshipPartnershipCorporationLLC
Sales Rep

Business and Credit Info
Accounts Payable Contact*

First NameLast Name
Accounts Payable Phone*

Area CodePhone Number
Accounts Payable Fax

Area CodePhone Number
E-mail*
Company to Bill Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long at Current Address?
Website
FEID
DNB #
Expected Monthly Shipping

Bank Name*
Contact
Bank Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Checking Account #*
Savings Account #
Loan Account #

Business References

If your company has credit sheet please upload below and you can skip typing the information in
Upload References

Browse Files

Cancelof
Reference 1: Company Name*
Contact

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Fax Number

Area CodePhone Number
E-mail
Reference 2: Company Name*
Contact

First NameLast Name
Address 2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number 2*

Area CodePhone Number
Fax Number 2

Area CodePhone Number
E-mail
example@example.com

Agreement

(By checking these boxes you are agreeing to our terms - should you have any questions please contact us)
Agreement and Terms*

Logistics Worldwide guarantees the integrity of quoted rates with the exception of reclassifications, shipment reweighs, and accessorial charges. Customers shall pay each shipment processed through Logistics Worldwide at the full invoiced amount. The invoiced amount could include extra charges assessed by the carrier for accessorials, reweighs, reclassifications or dry-run fees. Accessorial charges cannot be corrected after the shipment has been tendered. Logistics Worldwide will assist in researching the reweigh and reclassification charges. If such charges are reduced, Logistics Worldwide will issue a credit for the difference back to the Customer. Logistics Worldwide will not be responsible for any freight claims that are denied for any reason by the specified carrier.
Agreement and Terms*

Customer agrees to (1) Credit Terms of NET 15 DAYS from invoice date, and (2) in the event it becomes necessary for Logistics Worldwide to either bring suit or employ a collection agency to assist in the recovery of any debt owed by the Customer, Logistics Worldwide shall be entitled to recover, in addition to the amount of debt due, all of its costs and attorneys fees. Customer grants Logistics Worldwide a general contractual lien on all property tendered for transportation against any past due charges, which lien shall apply regardless of whether the past due charges are to the goods against which the lien is claimed, all subject to applicable state law.
Agreement and Terms*

The signature below (1) authorizes Logistics Worldwide to charge interest on outstanding balances over 15 days old at an annual percentage rate of 12% or to the extent permitted by law, (2) authorizes the above listed bank and trade references to release any requested information to Logistics Worldwide for use in the evaluation of this request for credit extension, (3) authorizes Logistics Worldwide to ACH (Automated Clearing House) your checking account for any invoices over 60 days, and (4) acknowledges that Customer has read Logistics Woldwide’s terms and conditions (linked below) and agrees to be bound by their terms. To read complete terms and conditions, please www.logisticsworldwide.com
Should be Empty:

Business Contact Info

Business and Credit Info

Business References

Agreement