Credit Application & Agreement

Thank you for your request to become a Credit Customer of Rexway Transport. This Credit Application & Agreement (the “Application”) must be fully completed, signed & returned by you (the “Applicant”) before your credit request will be considered. The applicant by its duly authorized representative having full knowledge of the information required to be provided in the Application, hereby represents and warrant that all information given in this Application is complete and accurate. The Applicant acknowledges that Rexway Transport shall be relying upon all information contained herein in extending any credit to the Applicant. If Rexway Transport agrees to extend credit to the Applicant, such credit may be cancelled at the discretion of Rexway Transport if any information provided by Applicant, whether in this Application, Schedule or otherwise, shall prove to have been inaccurate, misleading or incomplete as determine by Rexway Transport. This agreement governs all sales to you by Rexway Transport.

General Information
Legal Business Name:  Date Business Established:
Trade Name (if any): Is Company a Division?:  
Address: City:
Province: Postal Code:
Phone: Fax:
Address: City:
Province: Postal Code:
Nature of Business:
Is Business Location owned?:  
If rental, landlord's name: Landlord's phone:
Ownership Information (Partnership, Sole Ownership)
Principal Owner name: Title:
DOB (for ID purposes):
Banking Information
Bank name: Branch Address:
Branch Phone: Account Number(s):
Reference 1 name: Reference 1 Address:
Reference 1 Email: Reference 1 Fax:
Reference 2 name: Reference 2 Address:
Reference 2 Email: Reference 2 Fax:
Reference 3 name: Reference 3 Address:
Reference 3 Email: Reference 3 Fax:
Reference 4 name: Reference 4 Address:
Reference 4 Email: Reference 4 Fax:

Terms and Conditions