Credit Application (Topo)

Business and Credit Info
Accounts Payable Contact*

First NameLast Name
Accounts Payable Phone*

Area CodePhone Number
E-mail *
Accounts payable, if distinct from accounting and separate multiple with comma.
Company to Bill Address*

Street Address

Street Address Line 2

CityState

Zip Code
Original BOL(s)/POD(s)Copy of BOL(s)/POD(s)Your company's Reference NumberNone of the above.
CheckACH/Direct DepositCredit Card (coming soon!)
Credit Limit Requested.
Bank Name*
Bank Address*

Street Address

Street Address Line 2

CityState

Zip Code

Agreement

(By checking these boxes you are agreeing to our terms - should you have any questions please contact us. 423-205-3021 (ext. No. 2)
Reviewed and agreed to Top Logistics Broker-Client Agreement (Copy of Agreement will be provided upon completion of this form.)All invoices are to be paid 30 days from the date of the invoice. Remittance address: P.O. Box 429 Chattanooga, TN. 37401.Claims arising from invoices must be made within 7 business days of the invoice date.By submitting this credit application, you authorize us to make inquires into the banking and buisness references that you provided.
W9*

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Please upload a signed copy of your company's W9. Cancelof
Any additional paperwork for us to file and/or complete.

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You may also email us your paperwork at paperwork@topolgx.com Cancelof
If you're a human, click below.*
Signature

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Business and Credit Info