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2812 70th Ave. E.,
 Fife, WA 98424

(253) 926-3292
(800) 426-9940
(253) 926-3161 Fax
info@pafak.com
 

Credit Application

Please print out, complete & fax to 253-926-3161

Click here for .PDF Format

 

CREDIT APPLICATION
 


FIRM NAME :

 

DATE

CR. LIMIT APPROVED:

 

MAILING ADDRESS:                                                                                                                 CITY                                   STATE                         ZIP

FED ID#:

CR. LIMIT REQUESTED:

OFFICE ADDRESS:                                                                                                                     CITY                                  STATE                         ZIP

PHONE:

FAX:

TYPE OF BUSINESS:

(PLEASE CIRCLE ONE)

ƒ CORPORATION    ƒ PARTNERSHIP   ƒ SOLE OWNER    ƒ LLC

E-MAIL ADDRESS:

IN BUSINESS SINCE:

(If Partnership or sole Owner, please list individual social security number in appropriate space below.)

NAMES OF OWNERS, PARTNERS OR OFFICERS & HOME ADDRESS:

NAMES

TITLE

HOME ADDRESS

SOCIAL SECURITY NO.

 

 

 

 

 

 

 

 

 

 

 

 

IF FIRM OR PRINCIPLE OF, OPERATED UNDER ANOTHER NAME PLEASE LIST INFORMATION  BELOW:

HAS ANY PRINCIPLE OF THIS FIRM EVER FILED BANKRUPTCY?     ƒ  YES        ƒ   NO

(If yes, please state date of discharge ___________________)

Pending litigation:       ƒ YES         ƒ NO

EXPLAIN:

 

IF BUSINESS IS  BRANCH OR SUBSIDIARY, PLEASE LIST HEADQUARTERS NAME, ADDRESS & TELEPHONE NUMBER (IF DIFFERENT THAN ABOVE):

IF YOUR ACCOUNTS PAYABLE DEPT. IS NOT LOCAL PLEASE LIST BILLING ADDRESS, NAME OF MANAGER & TELEPHONE NUMBER;

 

 

 

 

 

 

CONTRACTOR’S LICENSE MUNICIPALITY LIC. NO. 

PLEASE LIST ANY SUGGESTIONS FOR BILLING THAT MAY EXPEDITE PAYMENT.

STATE LICENCE NO.:

 

 

BONDING INFORMATION (IF NOT LOCAL GIVE ADDRESS)                                           TYPE OF BOND:  ___________________________________________________________-

 

INSURANCE AGENCY OR BROKER:  _________________________________________________  BONDING CO, NAME: _____________________________________________

CREDIT REFERENCES

 NAME                         ADDRESS                                                                                              PHONE/FAX #’S                                                           ACCT#                                  CONTACT NAME

 

 

 

 

 

NAME OF BANK:                                                                             BRANCH:                                                         ACCT#:                                                                   PHONE#:                               CONTACT:

 

THE APPLICANT HEREBY AUTHORIZES THE CREDITOR TO CONTACT THE ABOVE FINANCIAL AND TRADE REFERENCES AND AUTHORIZES THE LISTED HERIN TO RELEASE ALL INFORMATION REQUESTED.  IT IS UNDERSTOOD THAT ALL INFORMATION WILL BE KEPT STRICTLY CONFIDENTIAL.

 

 

 

PLEASE READ AND SIGN NEXT PAGE OF THIS FORM

           

 Page 2 

For and in consideration of credit extended by Pacific Alaska Freightways, the undersigned hereby guaranties the full and timely payment of this account, including any service charges that may be incurred (not to exceed 1.5% per month or fraction thereof applicable on the unpaid balance) and/or legal fees if signing in a representative capacity of a principle, partnership, corporation, or otherwise.  Should credit availability be granted by seller/creditor, all credit shall be extended at the discretion of the creditor.  Creditor may increase, decrease, or terminate any credit availability at any time within its sole discretion.  If credit is extended by Pacific Alaska Freightways, no payment will be recquired at the time of delivery.  Freight bills are due 30 days after the invoice date.  A written statement setting forth the unpaid principal balances will be furnished on or about the first day of succeeding calendar month.  In the event that the entire account balance is not paid on or by the net due date as shown on each invoice, at the option of Pacific Alaska Freightways, may be declared to be delinquent.  In the event that Pacific Alaska Freightways retains legal counsel to assist it in collecting a delinquent account, the undersigned promises and agrees to pay all reasonable legal costs and attorney’s fees as well as collection fees if turned to an outside agency actually incurred by Pacific Alaska Freightways.  The terms and conditions of this application shall, upon extension of credit by the company, constitute an agreement of sales.

  

                Pacific Alaska Freightways reserves the right to retain shipments in its possession until charges due on these shipments and on prior shipments are paid in full.  Consignees are hereby placed on notice that their goods may be held until both the freight charges on the particular shipments, as well as any prior debts of the consignor, consignee, or party liable to pay the freight bill, are paid in full, even though these debts may arise from shipments to persons wholly unrelated to the consignee.  Pacific Alaska Forwarder’s right to retain a current shipment for payment of charges due on a prior shipment is a “Cross-Over lien.”

  

                Venue shall be in Pierce County, Washington State.  Any sales that result from an extension of credit by seller shall be construed under the laws of Washington and any lawsuit resulting from this extension of credit may be commenced in the State of Washington.  The parties hereto knowingly and intentionally waive the right to a jury trial on any issue or dispute that may arise between them.

  

The undersigned hereby consent(s) to Pacific Alaska Forwarder’s use of a non-business, consumer credit report on the undersigned in order to further evaluate the creditworthiness of the undersigned as principal(s), proprietor(s) and/or guarantor(s) in connection with the extension of business credit as contemplated by this credit application.  The undersigned hereby authorize(s) Pacific Alaska Freightways to utilize a consumer credit report on the undersigned from time to time in connection with the extension and continuation of the business credit represented by this credit application.  The undersigned as {an} individual(s) hereby knowingly consent to the use of such credit report consistent with the Federal Fair Credit Reporting Act as contained in 15 U.S.C. @1681 et seq.

  

                I/we hereby certify that the information given is true and has been given for the extension of credit for business purposes.

 

Signed by:_________________________               Signed by:_________________________               Signed by:_____________________________

 

Print name:________________________              Print name:________________________              Print name:_____________________________

 

Title:_____________________________             Title:_____________________________             Title:__________________________________

 

Date:_____________________________              Date:______________________________            Date:__________________________________

 

For (Company Name): _____________________________________________________________________________

 

 

                The undersigned individual(s) in consideration of the company’s extension of credit to the applicant hereby agrees to personally guarantee any and all obligations of the applicant and the company.  This guaranty shall be continuing and unlimited and may be terminated only on 30 days’ written notice to Pacific Alaska Freightways.  The company may exercise its rights under this guaranty without first taking any action against the applicant.  The undersigned waives notice of default and non-payment, and consents to the extension or modification of credit terms to the applicant without notice.

 

 

 

Dated                                       Witness                                                                    Guarantor

 

 

 

 

 

 

 

 

 

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