Credit Application Form – Aim Equipment Rentals

CREDIT APPLICATION

Company:
SS Patronal
Postal Address:
Physical Address:
Office Number:*
Fax:
Email*
Type of Business:
In Business Since:
Date Format: MM slash DD slash YYYY
Contact Accounts Payable
Email Accounts Payable
Phone Accounts Payable
Name and phone of Contact or Close Relative
Officers and/or Partners
Title
Social Security #
Address
Phone Number
Email
Account Reference
Bank Name*
Bank Branch*
Account Number*
Commercial Account References (Suppliers)
Name*
Address*
Account No.*
Phone Number & Fax*
*
*
*
*
If it is subcontracted by another company, please indicate company name, address, telephone number, email address, contact person.
If you grant me the credit requested here, the undersigned agree to pay for all products, equipment, parts and/or services purchased, in a period of thirty (30) days from the date they incur the obligation, unless by written agreement between the parties said term be modified. Any obligation incurred by the undersigned that is not paid, satisfied within the term indicated above or in the period agreed upon by written, will accrue interest at 10% annually up to its total balance and in addition will accrue a 3% late charge. In the event of If it is necessary to use the services of a lawyer to collect the debt incurred by the applicants, they are obliged to pay a additional sum equal to 25% of the balance due to cover fees and costs, or the amount currently incurred, the whichever is greater.
I authorize AIM Rentals to request and/or verify any information provided here*
Date Format: DD slash MM slash YYYY
Please provide a copy of the Merchant Registry (Registro de Comerciante)
Phone
This field is for validation purposes and should be left unchanged.

CREDIT APPLICATION

Account Reference

Commercial Account References (Suppliers)

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