Business Credit Reports

Company Information

Company Name

Address

City

State/Province

Zip/Postal Code

Country

Phone

Fax

Billing Address

Billing City

Billing State/Province

Billing Zip/Postal Code

Tax Identification #

# of Years in Business

Website

Legal Form (Corporation, Partnership, or Proprietorship)

Total Company Revenue

Miscellaneous Questions

Please provide the invoice processing email address.

Do you require a PO? (Yes/No)

Payment Method: ACH Preferred. Credit Card or Company Check is Optional with Processing Fee applied

Bank Name

Bank Routing/ABA Number

Bank Account Number

Contact Information

First Name

Last Name

Title

Phone

Fax

Accounts Payable Contact Information

First Name

Last Name

Title

Phone

Fax

Bank References

Bank

Account #

Phone

Contact

Address

City

State

Zip

Fax

Bank Name

Type of Account (Savings, Checking, Other)

Parent Company Information

Company

Address

City

State

Zip

Country

Credit Reference #1

Company

Contact

Phone

Fax

Address

Account #

Credit Reference #2

Company

Contact

Phone

Fax

Address

Account #

Credit Reference #3

Company

Contact

Phone

Fax

Address

Account #

Request

Requested Amount

Comments (400 characters max)

Supporting Documentation

If applicable, please upload tax identification and W-9.

Click the Browse / Choose Files button above to select the files you want to send. Then click the Upload button.
Please keep individual file sizes to 4MB or less.

Uploaded Documents

Terms

Net 30/Other. (Other payment terms must be agreed upon in writing by both parties prior to account setup.)

I accept the above terms.

Please Sign Below

Using a touchpad or mouse, please sign in the area below. When finished signing, please click the Save Signature.

Submit the Request

By clicking 'Submit', I/We authorize B&B Logistics, LLC and/or B&B Brokers, LLC 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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