325 S College Ave.
Indianapolis, IN 46202
Phone: 800-632-1760
Fax: 317-522-1550
E-mail: [email protected]
www.transjetcargo.com
TransJet Cargo, LLC
SHIPPER CREDIT APPLICATION
CompanyName
Address
City/State/Zip
BillingAddress(ifdifferent):
Phone Fax Email
Shipping Contact Payable Contact
Special Billing Requirements
Year Established Federal Tax ID# DUNS#
Business Structure (select one) Corp. Partnership Sole Prop. LLC .
BANK INFORMATION
Name of Bank
Contact Person Phone Fax
Account Numbers
THREE CARRIER REFERENCES
Carrier Phone Fax
Carrier Phone Fax
Carrier Phone Fax
I agree to and will abide by these TransJet Cargo, LLC (TJC) policies:
1. We agree to immediately notify TJC of any change of ownership, name, address, phone, etc.
2. If granted credit, our company agrees to pay our freight bills within 21 days of receipt.
3. In case of claim, any payments due TJC will not be subject to withholding in lieu of insurance settlement.
4. I authorize the release of credit information to TJC, which will be held in strict confidence by TransJet Cargo LLC.
5. If outside collections are required, we agree to pay for reasonable attorney and collection related costs. We
acknowledge that amounts past due may be charged interest at the maximum legal rate.
6. We understand that TJC is a Broker and not a Carrier and that TJC does not assume liability as a Carrier.
7. I am an authorized representative of the company and have the authority to execute this document.
Shipper Name:
Signature
Print Name Title
TJC Truck Brokers Associate or Agent
Approved by:
