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Please fill out credit application below, sign and fax back to Veteran's
Livery: 781-335-4341
Charge Account Application
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The
following information will be needed for our Accounts Receivable Department.
Please type or print clearly.
| Date |
___________________________________________________________ |
| Firm
Name |
___________________________________________________________ |
| or
Individual |
MS./MRS./MR. ______________________________________________ |
| Social
Security # or TIN # |
___________________________________________________________ |
| Telephone
# |
___________________________________________________________ |
| Address |
___________________________________________________________ |
| City |
_________________________State_______________Zip____________ |
| How
long? |
___________________________________________________________ |
If
less than 3 years,
give previous address |
___________________________________________________________ |
|
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| Owner
of business (name) |
___________________________________________________________ |
| Address |
___________________________________________________________ |
| Social
Security# of Owner |
___________________________________________________________ |
| Type
of Business |
___________________________________________________________ |
| Employed
by Telephone # |
___________________________________________________________ |
| How
long employed |
___________________________________________________________ |
| Address |
___________________________________________________________ |
| City |
_________________________State_______________Zip____________ |
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Please
give name and exact address you desire statement sent.
(If statement is not paid locally, please give name
and address of Accounts Payable Division where statement is paid)
| Firm
name or individual |
___________________________________________________________ |
| Billing
Address |
___________________________________________________________ |
| City |
_________________________State_______________Zip____________ |
| Attention |
___________________________________Department______________ |
Person
responsible
for payment |
___________________________________________________________ |
| Telephone
# |
___________________________________________________________ |
| Address |
___________________________________________________________ |
| City |
_________________________State_______________Zip____________ |
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Business
References
| Name |
___________________________________________________________ |
| Account
# |
___________________________________________________________ |
| Address |
___________________________________________________________ |
| Telephone
# |
___________________________________________________________ |
| Name |
___________________________________________________________ |
| Account
# |
___________________________________________________________ |
| Address |
___________________________________________________________ |
| Telephone
# |
___________________________________________________________ |
| Name |
___________________________________________________________ |
| Account
# |
___________________________________________________________ |
| Address |
___________________________________________________________ |
| Telephone
# |
___________________________________________________________ |
| Name |
___________________________________________________________ |
| Account
# |
___________________________________________________________ |
| Address |
___________________________________________________________ |
| Telephone
# |
___________________________________________________________ |
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Bank
References
| Bank |
___________________________________________________________ |
| When
opened? |
___________________________________________________________ |
| Account
# |
___________________________________________________________ |
| Bank |
___________________________________________________________ |
| When
opened? |
___________________________________________________________ |
| Account
# |
___________________________________________________________ |
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In
order to provide better service to you, would you kindly provide us
with the following information:
Do you have a loading dock or a delivery zone located at your building?
Yes No
Where is it located?
If you do not know where the delivery or loading zone is located,
would you kindly write the name and phone number of the Building Manager
or Management Company. Thank you.
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Name
of Building Manager
or Management Company |
___________________________________________________________ |
| Telephone
# |
___________________________________________________________ |
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IMPORTANT
PLEASE READ BEFORE SIGNING
It is further understood, when a voucher book is issued,
this book shall remain the property of Veteran's Livery, and may be
revoked at any time. Upon revocation all voucher books in your possession
shall be surrendered to said Service upon demand. Accounts 30 days
PAST DUE will be charged 1 1/2% interest each month on the unpaid
balance. STATEMENTS ARE PAYABLE UPON RECEIPT. The recipient to whom
this charge voucher book is issued hereby assumes all responsibility
for payment of the charge vouchers whether lost or stolen. On Company
accounts, the owner(s) will be personally liable for any voucher charges
incurred. |
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| Authorized
signature |
___________________________________________________________ |
| Title |
___________________________________________________________ |
| Please
print last name |
___________________________________________________________ |
Owner's
signature
required on
Company's accounts |
___________________________________________________________ |
| Title |
___________________________________________________________ |
| Please
print last name |
___________________________________________________________ |
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