FRONTLINE FREIGHT ACCOUNT APPLICATION

FRONTLINE FREIGHT ACCOUNT APPLICATION
COMPANY NAME
DATE ESTABLISHED

Month Day Year
Date
Address

ADDRESS

Street Address Line 2

CITY/STATE/ZIP
PHONE
FAX
E-MAIL
example@example.com
ACCOUNTS PAYABLE CONTACT
PHONE
FAX
ACCOUNTS PAYABLE CONTACT
E-MAIL
example@example.com
FEDERAL TAX ID #
BANK PHONE
FAX
ACCOUNT MANAGER
E-INVOICING
E-MAIL

WOULD YOU LIKE TO RECEIVE ELECTRONIC INVOICING? Yes
E-MAIL
example@example.com
REFERENCES (COMPANIES CURRENTLY EXTENDING YOU CREDIT):
COMPANY NAME
CONTACT
ADDRESS

STREET

Street Address Line 2

CITY/STATE/ZIP
PHONE
FAX
E-MAIL
example@example.com
COMPANY NAME
CONTACT
ADDRESS

STREET

Street Address Line 2

CITY/STATE/ZIP
PHONE
FAX
E-MAIL
example@example.com
COMPANY NAME
CONTACT
Address

ADDRESS

Street Address Line 2

CITY/STATE/ZIP
PHONE
FAX
E-MAIL
example@example.com
The information provided is for the purpose of obtaining an account and/or establishing credit with Frontline Freight, Inc. I certify that all information provided is correct. I understand Frontline's credit terms require payment within 30 days and agree to comply with those terms. By my signature I am authorizing the release of credit information from the references listed above. All terms and conditions of Frontline's Governing Rules Tariff (FCSY 101) are to apply to Frontline's extension of credit. I am also aware that copies of governing tariff publications are available directly from my Account Executive or by request to Frontline's Pricing Department.
Please write the following statement below: “I have read and agree to Frontline’s payment terms."
SIGNATURE

Clear
TITLE
PRINT NAME
DATE

Month Day Year
Date
240 S 6 AVENUE | CITY OF INDUSTRY, CA 91746 | TOLL-FREE: 800-243-5422 | DIRECT: 562-236-1440 | FAX: 562-236-1452
Should be Empty:

FRONTLINE FREIGHT ACCOUNT APPLICATION

E-INVOICING

REFERENCES (COMPANIES CURRENTLY EXTENDING YOU CREDIT):