Shipper

Ship Anything, Anywhere: DXL Covers All Your Shipping Needs.

BUSINESS CONTACT INFORMATION

Title:

Company Name:

Phone:

Fax:

E-mail:

Registered company address:

City:

State:

ZIP Code:

Date business commenced:

Proprietorship:Partnership:Corporation:Other:

BUSINESS AND CREDIT INFORMATION

Primary business address:

City:

State:

ZIP Code:

How long at current address?

Telephone:

Fax:

E-mail:

Bank name:

Bank address:

Phone:

City:

State:

ZIP Code:

Type of account:

Account number:

BUSINESS/TRADE REFERENCES

Company name

Address:

City:

State:

ZIP Code:

Phone:

Fax:

E-mail:

Type of Account:

AGREEMENT

1. All invoices are to be paid 30 days from the date of arriva
2. Claims arising from invoices must be made within seven working days.
3. By submitting this application, you authorize Direct Xpress Logistics, Inc. to make inquiries into the bankingand business/trade references that you have supplied.
4. By signing this application you accept Direct Xpress Logistics, Inc. Terms & Conditions

SIGNATURES

Printed Name:

Signature Name

Shipper

Ship Anything, Anywhere: DXL Covers All Your Shipping Needs.

BUSINESS CONTACT INFORMATION

BUSINESS AND CREDIT INFORMATION

BUSINESS/TRADE REFERENCES

AGREEMENT

SIGNATURES

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