Idealease Credit App

Step 1 of 2

Company Name(Required)

Billing Address:

Physical Address:

Phone

Fax

Email(Required)

Type Of Ownership

Corporation

Parternship

Year of incorpation

Number of Year in Business

Type of Business Operated

Number of Trucks/owned Operated

Credit Line Requested

If ICC Carrier,Please Include Number

US Dot#

Principal Owner/ Person responsible for payment on account :

Application For credit is hereby made and the following refrence given.It understood that this information will be held in strictest confidences and used only only by the credit department

Bank Account

Location

Phone

Contact:

BUSNIESS REFRENCES WHERE CREDIT IS NOW EXTENDED PLEASE DO NOT USE CREDIT CARDS ,FUELS CARDS PHONE, UTILITY ,FOR REFRENCES

References

Name

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Name

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Name

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Name

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code Country

THE FOLLOWING ARE AUTHORISED TO ORDER /SIGNON ACCOUNT

PLEASE LIST SPECIAL BILLING INSTRUCTION :

Signature(Required)

Date

In the event that credit is extended by White's Idealease, LLC, the undersigned agrees as follows:

Payment due in 10 days from date of invoice.
On any unpaid balance not paid by the end of the following month a service charge of 11/2% per month (18% A.P.R.) will be charged.
Any account past due over 30 days may be placed on C.O.D. and credit privileges withdrawn.
Any account past due over 60 days may be closed.
Pay reasonable attorney fee and court costs incurred in enforcing collection on the account.

I hereby and personally absolutely and unconditionally guarantee payment of any and all accounts, credit balances and debts of any kind, now or hereafter due and owing by the applicant to Herring, it's successors and assigns. This guaranty shall be continuing and irrevocable for any such indebtedness. I hereby waive notice of default, nonpayment and notice thereof and consent to any modification or renewal of the credit agreements hereby guaranteed. If this guaranty is placed for collection or any legal expense is incurred to enforce or preserve any of our rights or claims, the undersigned agrees to pay all costs thereof, including attorney's fees in the maximum amount allowed in the state of the undersigned or the business, but not less than 15% of the outstanding balance when placed for collection. The undersigned agrees: (1) this guaranty shall be construed in accordance with the laws of the state of North Carolina; (2) any dispute arising under this guaranty shall be adjudicated in the state courts of North Carolina in Wilson County and in no other forum; (3) this guaranty was finally accepted in North Carolina and (4) the undersigned submits to the jurisdiction of the state courts of North Carolina and waives any defense of improper or inconvenienct venue in said state.(Required)

I agree to the statement above.

GUARANTEES PAYMENT FOR ALL PARTS AND SERVICE PURCHASED.

Print Name

Date

Signature

Type Of Ownership

Application For credit is hereby made and the following refrence given.It understood that this information will be held in strictest confidences and used only only by the credit department

BUSNIESS REFRENCES WHERE CREDIT IS NOW EXTENDED PLEASE DO NOT USE CREDIT CARDS ,FUELS CARDS PHONE, UTILITY ,FOR REFRENCES

References

In the event that credit is extended by White's Idealease, LLC, the undersigned agrees as follows:

GUARANTEES PAYMENT FOR ALL PARTS AND SERVICE PURCHASED.

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