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CREDIT APPLICATION AND AGREEMENT - Crowley …

CREDIT Limit Requested $_____. CREDIT APPLICATION AND AGREEMENT . FULL LEGAL NAME_____ DATE_____. MAILING ADDRESS_____. _____. PHONE_____ STATE / COUNTRY OF INCORPORATION_____. Year established _____ __ Number Of Employees _____ DUNs Number:_____. OWNERSHIP: CORPORATION PARTNERSHIP SOLE PROPRIETORSHIP. FEDERAL TAXPAYER NUMBER (OR SOCIAL SECURITY NUMBER) _____. BILLING INFORMATION. BILLING ADDRESS _____. ACCOUNTS PAYABLE CONTACT_____ PHONE _____. ACCOUNTS PAYABLE EMAIL ADDRESS _____. PRIMARY AP CONTACT OR PAYING AGENT_____. OTHER BUSINESS NAMES USED _____. NAMES OF SUBSIDIARIES / AFFILIATES_____. BANK INFORMATION. PRIMARY BANK NAME_____ CONTACT_____. PHONE_____ ACCOUNT(S) ADDRESS_____. TRADE REFERENCES. COMPANY NAME_____ PHONE_____. ADDRESS_____ CREDIT LIMIT_____.

As consideration for the grant to Applicant of Credit with respect freight or other charges in connection with services provided by Crowley Holdings, Inc.

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