Credit Application

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Required Information

Physical Address
Billing Address
Primary Business

Company Classification

Accounts Payable Information

Accounts Payable Contact
Will we invoice a third party payment processor?
Will we invoice other locations?
I.e Chicago office, New york office, Houston office.

Invoicing Requirements

Please select what is required when invoicing
Do you have the ability to pay via ACH/Wire?

Bank Reference

Bank Representative

Credit References - Minimum of 2 References

Credit Reference #1

Contact Name

Credit Reference #2

Contact Name

Credit Reference #3

Contact Name

General Terms And Conditions

I Accept The Terms And Conditions Contained In this Agreement
Credit will be extended on the condition that customer agrees to make payment in accordance with the terms of the invoice. Customer will not delay or withhold payment due to the alleged errors in billing or because of any other dispute customer may have with JDSB Trucking or its affiliates or subsidiaries. Failure to make timely payments to JDSB Trucking or its affiliates or subsidiaries may result in cancellation of any credit extended. Any account that warrants collection action will be responsible for all associated collection fees including but, not limited to, attorney’s fees, court costs, collection agency fees and interest at the rate of two percent (2%) per month. Customer hereby acknowledges that it is applying for credit with a company whose principal place of business is located in Illinois. Customer agrees that it is availing itself to the jurisdiction and laws of Illinois with respect to this credit application and any claim involving or relating to the extension of credit and payment of bills hereunder. Customer agrees to submit to the jurisdiction of Illinois with any suit related thereto. Customer waives any argument or claim that Illinois lack jurisdiction over Customer and agrees to personal and subject matter jurisdiction in Illinois. Customer agrees to JDSB Trucking's attorney fees and costs related to any contest to jurisdiction in Illinois. Customer agrees to terms and conditions of JDSB Trucking Rules Tariff JDSG-100 as presented on www.jdsbtrucking.com. By checking accept, you are agreeing to these terms and conditions and are acklowging that you have read and understand Rules Tariff JDSG-100
Name
Clear Signature
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