Business Credit Reports

Company Information

Company Name

Tax Identification #

Address

City

State/Province

Zip/Postal Code

Country

Phone

Fax

Type of Business

# of Years in Business

President / Mgr

DUNS #

A/P Contact

Email Address

Phone #

Where Do We Email Your Invoices?

Contact Information

First Name

Last Name

Title

Phone

Billing Requirements

Copy of Bill of Lading (Yes/No)

Purchase/Sales Order Required (Yes/No)

Interchanges (Yes/No)

Reference Number (Yes/No)

Credit Card (Yes/No)

Other

Preferred Chassis Provider

Chassis Provider

Free Days

Comments (special agreement with Chassis Provider)

Chassis Provider

Free Days

Comments (special agreement with Chassis Provider)

Per Diem

Steamship Line

Free Days

Comments (special agreement with steamship line)

Steamship Line

Free Days

Comments (special agreement with steamship line)

Certificate of Insurance Information

Legal Company Name

Company Address

City

State

Zip Code

Special Language

Bank References

Bank Name

Address

City

State

Zip

Officer

Account #

Phone

Credit Reference #1

Name

Address

City

State

Contact

Account #

Phone

Credit Reference #2

Name

Address

City

State

Contact

Account #

Phone

Credit Reference #3

Name

Address

State

City

Contact

Account #

Phone

Request

Requested Amount

Comments (400 characters max)

Supporting Documentation

Please upload a copy of your W-9 and Tax Exempt Certificate, if applicable.

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Uploaded Documents

Terms

Our standard credit terms are Net 30 days.

I accept the above terms.

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By clicking 'Submit', I/We authorize Sunburst Truck Lines or its agent to obtain a credit report for the purpose of establishing, maintaining or enforcing a credit relationship. Upon approval of credit, I/We agree to pay our account according to the terms granted and I/We acknowledge that I/We have read and fully understand this application.

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