Lift Truck Rental | Kansas City MO

Credit Application Form

Return Fax To:

816-241-8619

ATTN: Accounting

CREDIT APPLICATION

LIFT TRUCK SALES & SERVICE

2720 Nicholson Rd .

Kansas City, MO 64120

(816) 241-6360 - Fax (816) 241 -8619

Credit Application Form

Free Text

If not applicable, please put N/A

ATTN:

Company:

Address:

New Field:

Area Code & Phone

Area Code & Fax

How long in business?

Contact Person

Title

Billing Address (if different)

Do you claim tax exempt? (If yes, completed exemption certificate must be on file)

Yes

Check One

Corporation

Partnership

Sole Proprietorship

Purchase Order Required:

Yes

Corporate Officers:

Corporate Officers:

President :

MUST PROVIDE SOCIAL SECURITY # OR FEDERAL TAX 1.0. #

Trade References

Bank References

Free Text

BY EXECUTION OF THIS APPLICATION FOR CREDIT, WE HEREBY AUTHORIZE THE RELEASE OF ANY AND ALL CREDIT INFORMATION BY OUR BANK AND/OR TRADE REFERENCES NECESSARY FOR THE PROCESSING OF THIS CREDIT APPLICATION.

SIGNATURE

TITLE

Phone: 816-241-6360

Address: 2720 Nicholson Ave. Kansas City, MO 64120

Phone: 417-501-8002

Address: 2102 Roosevelt Ave. Suite #2 Joplin MO 64804

BUSINESS HOURS

Monday-Friday 8 am – 4:30 pm

Closed Saturday and Sunday

Phone: 816-214-6360

Address: 2720 Nicholson Ave. Kansas City,

MO 64120

Phone: 417-501-8002

Address: 2102 Roosevelt Ave. Suite #2 Joplin MO 64804

BUSINESS HOURS

Monday-Friday 8am – 4:30

Closed Saturday and Sunday