National Freight Management - CREDIT APPLICATION


Credit Application Fill out the following fields to begin processing your Customer Credit Application. Click the 'SUBMIT' button and the form will be automatically e-mailed to us.

*Business name:**
	Sole Proprietorship Partnership Corporation: Private Public Other
Address:
Billing Addr:
City/State:	Zip:
Province:
Country*:
Area/Phone*:	Ext:

Parent Co:
Address:
Type Business:
Date Established:	No. of Employees:


	FINANCIAL INFORMATION & CONTACTS
Bank:
Address:
Bank Officer:	Acct #:
Area/Phone:	Ext:
Annual Revenues:	Net Worth:
Annual Income:	Credit Need:
Federal ID#:	Dun & Brdst #:
Pres/Principal:
Accts Payable:
CFO/Controller:
Billing Contact:
E-mail:

	TRADE REFERENCES
Company:
Area/Phone:	Contact:
Company:
Area/Phone:	Contact:
Company:
Area/Phone:	Contact:
Company:
Area/Phone:	Contact:


Transportation organizations only:	Motor Carrier MC # Broker Other Surety Bond #

National Freight Management
2470 Walden Ave suite 200
Cheektowaga, NY 14225

Office:716-994-1392 Fax:716-741-9111

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