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Open Account

OPEN NEW ACCOUNT

The undersigned company is applying for credit with Capitol Courier and agrees to abide by the standard terms and conditions of Capitol Courier as stated below.

Company Name
Contact Name
Date Established
 
(if same as physical address leave blank)
Physical Address
Mailing Address
City
City
State
State
Zip
Zip
 
Your Phone #
Your Fax#
Your E-mail
A/P Contact
Would you prefer electronic billing?
YES
A/P Phone
A/P Email
A/P Address
City
State
Zip

TRADE REFERENCES
Reference
  
Name
  
Complete Address
  
Phone
  
How did you hear about us?
   
 
ACCOUNT CUSTOMIZATION
Is a Purchase Order or Job Reference required?
Do you need your invoices sorted by reference number? Yes No
Is the pick up/delivery made to the front desk or shipping/receiving? Front desk Receiving
Will orders be place via the internet? Yes No
   

GENERAL TERMS AND CONDITIONS AND PERSONAL GUARANTEE

Invoices are mailed after the first day of the month, although some accounts may receive weekly invoices per agreement. All invoices are due and payable within 30 days of invoice date and if not paid within that time period are considered past due. No additional credit will be extended to past due accounts unless satisfactory arrangements are made with our credit department.

 

I represent that the above information is true and accurate. My company and I authorize Capitol Courier to conduct a credit check, including contacting the above trade references and obtaining credit reports. My company and I authorize all trade references, and credit reporting agencies to disclose any and all information concerning the financial and credit history of my company and myself. By submitting this application I agree to all the terms and conditions set forth.

Company Name :
Printed Name:
Title:
Date: