Commercial Credit Application

"*" indicates required fields

Legal Name*

D.B.A*

Address*

Primary Account Contact:

Name*

Phone*

Email*

How did you you hear about us?

Billing Information: (Please check all that apply)

Primary Accounts Payable Contact: (where invoices will be sent)

Name*

Phone*

Email*

Requirements:

Requirements

P.O. Number

Reference Number

Please send a monthly statement

Other

Payment Options: (Please check one)

*Please do not enter any banking information on this application.

Requirements

I’d like to open a business account and pay at the time of service ( Card / Comchek / EFS / T Chek)

Credit/Debit card paid within 10 days of invoicing (4% processing fee added after 10 days)

Company Check mailed to P.O.Box 542 Union City, GA 30291 (net 30)

ACH Payment

Business to Business References: (business name, contact name, contact number)

Reference 1

Reference 2

Reference 3

It is at the sole discretion of Southside Wrecker Service to approve or deny this application.Terms are 30 days from the date of service rendered. Southside Wrecker Service reserves the right to suspend or cancel this account at any time for any reason. Past Due accounts will incur a 1.5% late fee for each month that current charges are unpaid.