ABCDEFGHIJKLMNOPQRSTUVWXYZ
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8990 Pascal Gagnon, St Leonard Quebec Canada
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PH: 514-955-0844 Fax: 514-955-7485
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Credit Application / Demande Douverture de Compte
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IDENTIFICATION
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Date:__________________
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Company's Name:
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Adress :
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City
Prov. / State:
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postal / Zip codeCountry
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Tel.:( ) Fax: ( )
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CONTACT : compte fournisseurs / accounts payable
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Name
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Billing Address
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Tel.:
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RÉFÉRENCE BANCAIRE / BANK REFERENCE
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Name of Bank:
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Branch address:
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Tel.: ( ) Account No.:
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contact:
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RÉFÉRENCES DE FOURNISSEURS / SUPPLIER REFERENCES
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1 - Name :Tel.:
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 Address:Fax :
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 City :
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2 - Name :Tel.:
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 Address:Fax :
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 City :
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3 - Name :Tel.:
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 Address:Fax :
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 City :
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TERMES / TERMS
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PLEASE NOTE THAT OUR CREDIT TERMS ARE 30 DAYS.
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All late payments will be charged interest at 2% per month (24% per year).
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It is agreed that Freight charges must not be withheld in the event of a claim or litigation.
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AUTORISATION / AUTHORIZATION
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I authorize P&B Transport to obtain or exchange information with any information agent towards
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establishing or verifying our financial standing.
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Client signature
 Position Date
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I, the undersigned, ______________________________, residing and domiciled at _______________________
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__________________________________
, stand as surety of _______________________________________
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I personnally, jointly, and severally, commit myself with ____________________________ to fulfill all
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obligations resulting from transport movements handled to P&B Transport Including the payment
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of freight charges and I do renounce to all benefits of division and discussion.
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Signature Caution / Surety
 Date
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