txquoteheader.gif (5775 bytes)
Master Credit Agreement

Please fill out the following form, then click the submit button and we will get back to you promptly.
Please notice that fields marked with an * must be filled out.

This message contains information which may be confidential and priviledged. If you are not an intended recipient, please refrain from any disclosure, copying, distribution, or use of this information and note that such actions are prohibited. If you have received this transmission in error, please notify by email txcredit@transx.ca



Company Name*
Physical Address*
Mailing Address*
City*
 Province/State*
Postal Code/ZIP*
 Email Address*
Telephone*
 Fax*
Accounts Payable Contact Name*

Business is*         Proprietorship Partnership Subsidiary Corporation
In the case of proprietorship or partnership, receipt of this form is our authorization to perform required credit reference checks on the business principal(s).

Names of Owners/Directors*
Nature of Business*
Length of Time in Business*
Gross Annual Revenue*
 Requested Line of Credit*
How would you like us to contact you* ?   Phone     E-mail     Fax

Bank Reference
Bank*
 Account Number*
Contact*
 Account Type*
Address*
 Telephone*
Fax
 Email Address

Trade References
(You must list at least one transportation company that you are currently dealing with)
Name*
 Contact*
Address*
 Telephone*
Fax
 Email Address
Name
 Contact
Address
 Telephone
Fax
 Email Address
Name
 Contact
Address
 Telephone
Fax
 Email Address

Company
Name of Authorized Person
Sales Representative

I/We, the authorized person(s) understand that the credit terms are 21 days upon receipt of the application and are subject to 2% interest per month, 24% per annum on overdue accounts.