Account Request Form

 

Feel free to submit this directly or to print and fax
(800-795-9USA) or mail to 15 Court Square #400, Boston, MA 02108

Opening an account gives you online ordering, tracking and reporting features for all your delivery needs.
We want to be your courier service solution.

Apply Today!

The undersigned company is applying for credit with USA Couriers, Inc, for courier services and agrees to abide by the standard terms and conditions of USA Courier, Inc. as printed below.
Corporation   LLP Sole Proprietor Partnership
Trade References
Reference #1 Name
Complete Address
Phone
Reference #2 Name
Complete Address
Phone
Reference #3 Name
Complete Address
Phone
Bank References
Primary Bank				Acct #
Complete Address
Phone	Contact Person
Account Customization
Is a Purchase Order or Job Reference required? Or NA
How many (average) packages do you send on a daily basis?
What are your company’s hours of operation?
Do you need your invoices sorted by reference number? YES    NO
Is there an after hour pick up or drop off location?
Is your company internet able?    Yes        No      Will orders be placed via the internet? Yes      No
Is there anything else we should know?
GENERAL TERMS AND CONDITIONS AND PERSONAL GUARANTEE
Bills are sent on the first day of the month, although some accounts may receive weekly or biweekly invoices per agreement. All bills are due and payable within 30 days of invoice date and if not paid within that time period are considered past due. All separate Overnight Delivery bills are due and payable within 15 days of invoice and if not paid within that time period are considered past due. No additional credit will be extended to past due accounts unless satisfactory arrangements are made with our credit department. I represent that the above information is true and is given to induce to extend credit to the applicant. My company and I authorize USA Couriers, Inc. to make such credit investigation as sees fit, including contacting the above trade references and banks and obtaining credit reports. My company and I authorize all trade references, banks, and credit reporting agencies to disclose to any and all information concerning the financial and credit history of my company and myself. By submitting this applications I am agreeing to have read, understood the terms and conditions stated above and agree  to all the terms and conditions set forth.
Authorized Signature or Electronic Signature:
Printed Name and Title:
Date:
Credit Card Payment Option
Type of Card   American Express Visa Mastercard Discover			Card Number
Expiration Date			Preferred date of monthly payment:
I authorize USA Couriers, Inc. to charge my credit card for services rendered.
Authorized Signature or Electronic Signature:
Printed Name on Card:
Date:

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