To apply for credit with Beacon Transit Lines., Inc., fill out all fields below. Be sure to read the application carefully. Incomplete applications will result in delays. Remember that all the information will be kept confidential. If you do not currently have all information needed, feel free to print this form and fax it when completed to
(416) 674-5733 or (416) 674-2293.

We hereby apply for the extension of credit by your firm and submit the following information as a basis for your consideration of our application. You are hereby authorized to investigate this information pertaining to our credit and financial responsibility.

DESIRED CREDIT LIMIT (Terms Net 15 Days): $


APPLICANT NAME:

TITLE:

EMAIL:

BUSINESS INFORMATION

LEGAL NAME OF COMPANY:

TRADE NAME or DBA/AKA, if applicable

ADDRESS

CITY

PROVINCE:

POSTAL CODE:

TELEPHONE:

FAX NUMBER:

Type of Business - please check one:
Proprietorship
Partnership  
Corporation
Nature of Business:

Years in Business:

BANK REFERENCE

BANK NAME:

ADDRESS

CITY

PROVINCE:

POSTAL CODE:

ACCOUNT NUMBER:

CONTACT NAME:

POSITION/TITLE:

TRADE REFERENCES: (TWO)

1) COMPANY NAME:

CITY

PROVINCE:

TELEPHONE:

CONTACT NAME:

2) COMPANY NAME:

CITY

PROVINCE:

TELEPHONE:

CONTACT NAME:

Please check the boxes below to indicate you have read and understood the terms and agree with them.

By submitting this application I/we give permission for BEACON TRANSIT LINES INC. to proceed with Credit Investigation as required. (Mandatory)
 
Should it be necessary to place this account for collection, I/we agree to pay all collection costs and legal fees. I/We also agree that if part payments are made or no payments are made on the account within the terms specified that you have the right to assess and I/we agree to pay a "finance charge" computed by applying a periodic monthly rate of 1% to the past due balance. This is an annual percentage of 12%. (Mandatory)
Please click the "Submit Application" button only once and allow time for the form to process.