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General Company Information
Name
(Required)
First
Middle Initial
Last
Name of Business
(Required)
Address
(Required)
Street Address
Address Line 2
City
State
Zip
Phone
(Required)
Type of Business
(Required)
In Business Since
(Required)
Legal Form Under Which Business Operates:
(Required)
Corporation
Partnership
Proprietorship
If Division/Subsidiary, Name of Parent Company
Parent Company In Business Since
Company Representative
Name of Company Principal Responsible for Business Transactions
(Required)
Title
(Required)
Address
(Required)
Address Line 2
City
State
Zip
Phone
(Required)
Email
(Required)
A/P Contact person
(Required)
A/P Contact phone: Tel:
(Required)
A/P Contact e-mail:
(Required)
Bank References
Institution Name
(Required)
Checking Account #
(Required)
Address
(Required)
Phone
(Required)
Institution Name
Checking Account #
Address
Phone
Institution Name
Checking Account #
Address
Phone
Trade References
Company Name
(Required)
Email
Contact Name
(Required)
Address
(Required)
Phone
(Required)
Account Opened Since
(Required)
Credit Limit
(Required)
Current Balance
(Required)
Company Name
Email
Address
Contact Name
Phone
Account Opened Since
Credit Limit
Current Balance
Company Name
Email
Contact Name
Address
Phone
Account Opened Since
Credit Limit
Current Balance
Accounting Department
Accounting Contact
(Required)
Phone
(Required)
Ext.
Email
(Required)
Invoices to:
(Required)
Statement of Account to:
Invoicing
Invoicing Options
(Required)
4 invoices- Load Ins, Load Outs, Tranporation and Storage Invoices
3 Invoices - Load Ins & Loads Out , Transportation and Storage
Invoice Frequency
(Required)
Each Transaction
Weekly
Monthly
Invoice Requirement
(Required)
Specific Information on invoices
Supporting Documents
Specific Information on invoices
Supporting Documents
Payment Options
Please select your desired method of payment
(Required)
Check
ACH
Outside of USA (upon request)
Payable To:
Universal Logistics Group 2240 75 th Street Woodridge, IL 60517
Beneficiary Bank:
First Eagle Bank
Routing:
71925017
Account:
132350401
Bank Address:
1201 W. Madison, Chicago, IL 60607
Contact:
Gerardo Gallo
Billing Department:
billing@unilogicgroup.com
I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein.
Signature
Date
(Required)
MM slash DD slash YYYY
General Company Information
Name
(Required)
First
Middle Initial
Last
Name of Business
(Required)
Address
(Required)
Street Address
Address Line 2
City
State
Zip
Phone
(Required)
Type of Business
(Required)
In Business Since
(Required)
Legal Form Under Which Business Operates:
(Required)
Corporation
Partnership
Proprietorship
If Division/Subsidiary, Name of Parent Company
Parent Company In Business Since
Company Representative
Name of Company Principal Responsible for Business Transactions
(Required)
Title
(Required)
Address
(Required)
Address Line 2
City
State
Zip
Phone
(Required)
Email
(Required)
A/P Contact person
(Required)
A/P Contact phone: Tel:
(Required)
A/P Contact e-mail:
(Required)
Bank References
Institution Name
(Required)
Checking Account #
(Required)
Address
(Required)
Phone
(Required)
Institution Name
Checking Account #
Address
Phone
Institution Name
Checking Account #
Address
Phone
Trade References
Company Name
(Required)
Email
Contact Name
(Required)
Address
(Required)
Phone
(Required)
Account Opened Since
(Required)
Credit Limit
(Required)
Current Balance
(Required)
Company Name
Email
Address
Contact Name
Phone
Account Opened Since
Credit Limit
Current Balance
Company Name
Email
Contact Name
Address
Phone
Account Opened Since
Credit Limit
Current Balance
Accounting Department
Accounting Contact
(Required)
Phone
(Required)
Ext.
Email
(Required)
Invoices to:
(Required)
Statement of Account to:
Invoicing
Invoicing Options
(Required)
4 invoices- Load Ins, Load Outs, Tranporation and Storage Invoices
3 Invoices - Load Ins & Loads Out , Transportation and Storage
Invoice Frequency
(Required)
Each Transaction
Weekly
Monthly
Invoice Requirement
(Required)
Specific Information on invoices
Supporting Documents
Specific Information on invoices
Supporting Documents
Payment Options
Please select your desired method of payment
(Required)
Check
ACH
Outside of USA (upon request)
Payable To:
Universal Logistics Group 2240 75 th Street Woodridge, IL 60517
Beneficiary Bank:
First Eagle Bank
Routing:
71925017
Account:
132350401
Bank Address:
1201 W. Madison, Chicago, IL 60607
Contact:
Gerardo Gallo
Billing Department:
billing@unilogicgroup.com
I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein.
Signature
Date
(Required)
MM slash DD slash YYYY
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