Application For Credit
- Name of Firm or Individual
- Address (Physical & P.O. Box)
- City ST Zip
- Telephone Fax
- Amount of Credit Requested
- How did you hear about Jim’s Tank Service?
Please list three credit references
Please include business name, complete address, phone & fax number of reference
- First Reference
- Second Reference
- Third Reference
- Financial Institution
- Bank Officer
- Bank Address and Phone
- Dunn and Bradstreet Rating
- Federal I.D. Number
- Name(s) of Principal Owner (s)
Terms and Conditions
- Terms: net 30 days 1.5% assessed on past due accounts.
- We certify that all the information on this form is accurate and hereby authorize you to contact any listed reference or financial institution on this application for the purpose of verifying and establishing an account with ATM Oil Co., Inc./ Jim’s Tank Service, LLC.
- Failure to make payment within thirty days is basis for legal action to be taken and signer agrees to pay all court costs, reasonable attorney fees and any accrued interest on the past due account. Signer hereby waives all rights of exemption under the laws of the state of residence.
Sign and Date