Legal Business Name:
                  (List all Trade Names, d/b/a's; Divisions or Subsidiaries)

Street Address: City: State: Zip:

Mailing Address: City: State: Zip:

Phone: Fax: E-Mail:

Estimated Annual Sales: AP Contact Name & Phone:

Amount of Credit Requested: $ Type of Business: How Long in Business



Sole Proprietorship Owner SS#

Partnership Partner SS#

Partner SS#

Corporation/LLC President/Member

Vice President/Member



Federal Tax No. (If applicable) D&B No. Of applicable)



Bank Branch Phone

Address City State Zip

Officer Contact Acct. No.: Type of Acct.

Acct. No.: Type of Acct.

I hereby authorize bank named above to release information requested for the purpose of obtaining and/or reviewing credit.

D. CARRIER REFERENCES (Please till out 3 references)

Name Contact

Credit Application and Agreement p.2

The preceding information is for the purpose of obtaining credit and is warranted to be true. Applicant hereby authorizes Edge Logistics, LLC to investigate all references and customary credit information sources including consumer credit reporting repositories regarding our credit and financial responsibility for the purpose of obtaining credit and for periodic review for the purpose of maintaining the credit relationship. Applicant acknowledges that credit privileges, if granted, may be withdrawn at any time.

CREDIT POLICY: Invoices are rendered upon delivery of shipment.

CREDIT TERMS: All invoices are due 30 days from the invoice date. A service charge of one and one half percent (1 ½ % per month), or (18% per annum) or the highest legal rate, whichever is less shall be assessed on delinquent invoices unpaid after 60 days.

VENUE: Invoices are payable at Edge Logistics, LLC. This agreement is entered into in the state of New York and is governed by the laws of the state of New York. Any dispute relating to this Agreement shall be resolved in the State Courts of Brooklyn, NY.

CHANGE OF OWNERSHIP: Applicant shall notify Edge Logistics, LLC. in writing and by certified mail of any change in ownership, the name of the business or structure of the business under which credit is established.

In the event of default, and if this account is turned over to an agency and/or an attorney for collection, the undersigned agrees to pay all reasonable attorney fees, and/or costs of collection whether or not suit is filed.

We certify that this request is for the extension of credit for business purposes only and not for the extension of credit for personal, family or household purposes. The undersigned is authorized to execute this credit application on behalf of Applicant,

Edge Logistics, LLC Sales Representative Name:

Firm Name

By; Title

Authorized Executive Signature

Edge Logistics, LLC is an Equal Opportunity Employer