50 64th Avenue, Coopersville, MI 49404 | PH: (616) 997-0022 | www.AdvFleet.com

Credit Application
Company Name (Full Legal Name)
DBA (Doing Business As)

Billing Address
City
State
Zip

Physical Address
City
State
Zip

Billing Contact Person
Phone
Fax
E-Mail Address

Business Structure
Year Established
Federal Tax Id
Purchase Order Required

**TAX WILL CONTINUE TO BE CHARGED ON ALL INVOICES UNTIL THE APPROPRIATE”TAX EXEMPTION CERTIFICATE” IS RECEIVED. CUSTOMER WILL BE RESPONSIBLE FOR ALL TAX UNTIL CERTIFICATE IS RECEIVED.**

Trade References
(Do NOT list Financial Institutions, Tire, Fuel, Oil Companies, Credit Cards, or Dept Store Charges)
Name
Phone
Account #
Fax

Name
Phone
Account #
Fax

Name
Phone
Account #
Fax

 
Sales Agreement
I understand that my account is due 30 days from the date of the invoice, If my account is not paid by the 30th day, a 2% (24% per year) service charge will be applied. This charge becomes part of the unpaid balance and is non-negotiable. If my account is not paid by the 15th of the third month, my account will be placed in restricted status, by signing below, I , the signer, personally guarantee the balance will be paid. Any cost incurred in collecting debts will be the responsibility of the application signer. Arrangements to pay off balance must be made only with the Accounts Receivable Manager of Advantage Fleet Parts LLC.

Application Signature
Date
Full Name & Title
Date