Falcon Credit Term Application Form

Credit Term Application

CONFIDENTIAL
Your Falcon Sales Rep. Name
BILLING INFORMATION
Registered Business Name*
Trade Name (DBA if any)
Invoicing/Billing Address*
City*
State/Province*
Zip/Postal*
Principals Partners/Owners/Officers – Name and title
Principal-1*
Title*
Principal-2
Title
Phone/Ext:*
Format: (000) 000-0000.
Direct Line/Mobile:*
Format: (000) 000-0000.
Email:*
example@example.com
SHIPPING INFORMATION (if different)
Shipping Address
City
State/Province
Zip/Postal
Shipping/Receiving Contact
Shipping Contact Person Name*
Title*
Phone/Ext:*
Format: (000) 000-0000.
Fax:
Format: (000) 000-0000.
Email*
example@example.com
Business Entity*

Sole proprietorship:Partnership:Corporation:Other
Business Established (Month/Year)*
Type of Business (i.e. Wholesale, Retail, Service...etc.*
Primary Commodity*
Delivery Appointments Required?*

YesNo
Controller/AP Contact Name*
Controller/AP Phone*
Format: (000) 000-0000.
Controller/AP Email*
example@example.com
Requested Term & Credit Limit (i.e. 30 days / $10,000)*
BILLING REQUIREMENTS (COPIES ONLY)
Including following items when sending billing documents:*

Invoice Copy OnlyBOL CopyPOD CopyREF#Other Documents Needed
Billing Contact Person Name (if different than Controller/AP Contact)
Phone (if different than Controller/AP Phone)
Fax
Email (if different than Controller/AP Phone)
example@example.com
U.S. Customs Broker Contact Information (if any)
Broker Company Name:
Phone
Fax
Email
example@example.com
BUSINESS BANKING INFORMATION
Name of Bank*
Address*
City*
State/Province*
Zip/Postal*
Phone:*
Format: (000) 000-0000.
Fax:*
Format: (000) 000-0000.
Branch, Institution No./Routing No.*
Account No.*
Account Manager Name
Email
example@example.com
BUSINESS/TRADE REFERENCES
Trade Partner - 01
Company Name*
Phone*
Format: (000) 000-0000.
Fax
Email*
example@example.com
Trade Partner - 02
Company Name
Phone
Format: (000) 000-0000.
Fax
Email
example@example.com
Trade Partner - 03
Company Name
Phone
Format: (000) 000-0000.
Fax
Email
example@example.com
TERMS AND CONDITIONS
Falcon Logistics Global Terms are full payment within 30 days of the date of the invoice.

Falcon's credit terms and conditions can be found in our website.

Full details at www.falconglobalusa.com
AUTHORIZED OFFICER or OWNER/PARTNER
Name (print)*
Title*
Signature*
Date*

MonthDayYear
Falcon Logistics Global Inc.
Should be Empty:

Credit Term Application

BILLING INFORMATION

SHIPPING INFORMATION (if different)

BILLING REQUIREMENTS (COPIES ONLY)

BUSINESS BANKING INFORMATION

BUSINESS/TRADE REFERENCES

TERMS AND CONDITIONS

AUTHORIZED OFFICER or OWNER/PARTNER