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LET'S GET YOUR INFO
Company Name
Phone Number
Mailing Address
City, State
Zip Code
Email
Credit Card Information
Credit Card Type
MasterCard
VISA
Discover
AMEX
Other
Credit Card Number
Cardholder Name
Expiration Date
Security Code/CVV
Amount
Billing Address
City, State
Cardholder ZipCode
Picture of ID (Front & Back)
Authorized Representative Signature
I authorize Flash Bolt Logistics LLC to charge my credit card for the agreed-upon purchases. I understand that my information will be stored for future transactions on my account.
Type/Print Name
Debtor Credit Application
Request A Credit Line
Yes
No
Bank Name
Address, City/State
Phone Number
Account Number
Account Number 2
Line of Credit or Loan
Title
Authorized Representative Signature
The undersigned authorized representative of the APPLICANT understands that the information provided herein will be relied upon for the purpose of extending trade credit. The representative hereby authorizes representatives or assignees of the vendor (collectively the “Vendor”) to contact the references listed below for the purpose of establishing an open credit line for the APPLICANT. The undersigned representative understands that during the credit investigation process, the Vendor may need to make inquiries with these references as often as necessary. The undersigned representative hereby authorizes the Bank and Trade References listed below to release information about the APPLICANT, including but not limited to payment history, NSF check experience, depository account status, and balance information. The undersigned representative also agrees to hold harmless all such references against any actions by the APPLICANT related to the dissemination of any information, whether positive or derogatory, to the Vendor.
Type/Print Name
Date when signed
Shipper Broker Agreement
Click here to read the Shipper Broker Agreement
Terms & Conditions
I, the undersigned, authorize Flash Bolt Logistics LLC to arrange transportation for my goods and agree to the terms and conditions, including payment within 30 days of invoicing, indemnification, and confidentiality. I understand Flash Bolt Logistics LLC acts as a broker and is not liable for cargo loss, damage, or delay.
Type/Print Name
Date when signed
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