Credit Application

You can contact our office by:

Phone: (909) 816-8961    

Fax: (909) 930-6140    

Send an email

Credit Application

Firm Name:
Date:
Contact Name:
Position:
Street Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
Business Type or Product Manufactured:
Year Established:
Business Type:
Will any parts purchased from Premier Trailer Service be for resale? (If “Yes” attach resale permit.)

Names of Business Principals:

Name of Owner/President of Company:
Street Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:

Other Contact/Partner/Corporate Officer:
Street Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:

Local Trade References and Bank References

Check the box if you will be submitting this information by mail or fax. Please be aware that using this option will delay processing of your application until this information is received.

Firm Name:
Contact Name:
Phone:
Fax:

Firm Name:
Contact Name:
Phone:
Fax:

Bank:
Phone:
Account No.

Billing Information

Street Address:
City:
State:
Zip Code:
Phone:
Accounts Payable Contact:
Purchase Order Required? Method of Submitting Invoices

As a representative of the above named company, the undersigned applies for open credit with Premier Trailer Service and gives authorization to obtain information from references listed for the purpose of approving this application. As a representative of the company, I acknowledge that our account terms with Premier Trailer Service are NET 30 days from the invoice date.

Authorized By: