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Credit Application

FIRM'S LEGAL NAME                              HOW LONG IN BUSINESS:

______________________________________________________      ____________________________

DBA'S:

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ADDRESS:                    CITY, STATE, ZIP               TELEPHONE:

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TYPE OF ENTITY:

(  ) CORPORATION          INCORPORATED IN STATE OF ____________        DATE INCORPORATED ______________

(  ) PARTNERSHIP

(  )  SOLE PROPRIETOR

NAME OF PRINCIPAL:

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ADDRESS:                                             TELEPHONE:

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2.    NAME OF PRINCIPAL:

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ADDRESS:                                             TELEPHONE:

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NAME(S) OF CORPORATE OFFICER(S):

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BANK REFERENCE

NAME:                                        ACCOUNT #:

_______________________________________________________     ____________________________     

ADDRESS:

_____________________________________________________________________________________

TELEPHONE:                         BANK OFFICER:

_____________________________________     __________________________________________

CREDIT REFERENCES

1.  BUSINESS NAME:                              TELEPHONE:

______________________________________________________     ____________________________

ADDRESS:                                   CITY, STATE, ZIP:

_____________________________________________________________________________________

CONTACT PERSON:

_____________________________________________________________________________________

2.  BUSINESS NAME:                              TELEPHONE:

______________________________________________________     ____________________________

ADDRESS:                                   CITY, STATE, ZIP:

_____________________________________________________________________________________

CONTACT PERSON:

_____________________________________________________________________________________

3.  BUSINESS NAME:                              TELEPHONE:

______________________________________________________     ____________________________

ADDRESS:                                   CITY, STATE, ZIP:

_____________________________________________________________________________________

CONTACT PERSON:

_____________________________________________________________________________________

OUR CREDIT TERMS ARE TWENTY ONE (21) CALENDAR DAYS FROM DATE SHOWN ON DOMESTIC CONTAINER TRANSPORTATION'S INVOICE.  SHOULD THE CREDIT TERMS AND/OR CREDIT LIMIT BE EXCEEDED AT ANYTIME, ALL FURTHER TRANSACTIONS WILL BE ON A CASH BASIS UNLESS FIRST APPROVED BY OUR CREDIT DEPARTMENT.

I HEREBY CERTIFY THAT ALL THE INFORMATION ON THIS FORM  IS CORRECT AND THAT I  FULLY UNDERSTAND THE CREDIT TERMS SET FORTH ABOVE.  I  AGREE TO THE PROPER PAYMENT IN CONSIDERATION OF EXTENDED CREDIT.  I  ALSO AGREE TO REIMBURSE DOMESTIC CONTAINER TRANSPORTATION FOR ANY LEGAL AND/OR COLLECTION FEES AND EXPENSES REASONABLY INCURRED IN ORDER TO ENFORCE THIS AGREEMENT.

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SIGNATURE OF OFFICER                    NAME (PLEASE PRINT LEGIBLY)

DATE: _____________________________________     TITLE: _____________________________

BANK CONFIRMATION FORM

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DATE

_____________________________________________________________________________________BANK NAME

_____________________________________________________________________________________ADDRESS

_____________________________________________________________________________________CITY, STATE, ZIP

ATTENTION: _________________________________________________________________________    

               ACCOUNT OFFICER

Dear Sir/Madam:

You are hereby authorized and requested to release credit information on the following account(s) to Domestic Container Transportation for their confidential use in determining our credit worthiness,

Account Name:     _______________________________________________________________________

Account Number:     ________________________________________________________________

_____________________________________________________________________________________

Account Name:     _______________________________________________________________________

Account Number:     ________________________________________________________________

Authorized Signature

_________________________________________          ___________________________________

Signature of Officer                         Name (Please Print)

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