Credit Application - Accurate Forklift, East Point GA

Business Name

Address

City

State

Zipcode

Billing Address (If Different)

Billing Address

Billing City

Billing State

Billing Zipcode

Billing Phone

Billing Fax

Business Contact

Contact Email

Accounts Payable Phone

Can we email you

Owner / Manger Name

Owner Manager Phone

How Long in Business

Federal ID #

Tax Exempt (Yes - No)

Dun & Bradstreet #

Trade References

References 1

Company Name / Contact

Address

Phone / Fax #

References 2

Company Name / Contact Name

Address

Phone / Fax

Bank References

Bank Name / Contact Name

Address

Phone / Fax

Bank 2

Bank Name / Contact Name

Address

Phone / Fax

Credit Line Requested

Pending Lawsuits

The undersigned authorizes inquiry as to credit information. We futher acknowledge that credit privileges, if granted, may be withdrawn at any time.

Name / Title

Our Power is down at the moment. Please call one of the numbers below.

Parts – Jeremy Jones – 770-789-8950
Service – Chris Benson – 678-967-1180
Rentals – JT Thompson – 770-712-1101
Reconditioned Parts – Shawn Dunaway – 239-249-0965

If any numbers are busy – David Reese – 770-605-4497

Cart

Cart

Cart

Credit Application - Accurate Forklift, East Point GA

Billing Address (If Different)

Trade References

References 1

References 2

Bank References

Bank 2

Cart

Cart

Cart

Credit Application - Accurate Forklift, East Point GA

Billing Address (If Different)

Trade References

References 1

References 2

Bank References

Bank 2

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