Credit Application Form - J&P Hall Express

Application for Credit:

Please Note: If credit is granted, our payment terms are Net 30 days unless otherwise noted.

If you have any questions regarding your application, you may contact Tammy Martin at 404-762-5063 or by email at tammym@jphallexpress.com. Mail or fax communication should be directed to:

J&P Hall Express
Attn: Credit Department
309 Cash Memorial Blvd
Forest Park, GA 30297
Fax: 404-762-9005

Business Information
Company Name*
Date*
Date Format: MM slash DD slash YYYY
Billing Address*
Street Address Address Line 2 City State ZIP Code
Location Address*
Same as Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Fax
Email*
Enter Email Confirm Email
Type of Business*
- Corporation
- Individual
- Partnership
- Subsidiary
Years in Business*
Please enter a number greater than or equal to 1.
Federal Tax Identification Number*
Contact for Accounts Payable*
First Last
Accounts Payable Email*
Credit References
Bank Name*
Account 1*
Account 2
Bank Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Contact Name*
First Last
Business References
Reference 1 Name*
First Last
Reference 1 Phone*
Reference 2 Name*
First Last
Reference 2 Phone*
Reference 3 Name*
First Last
Reference 3 Phone*
Terms
IF CREDIT IS GRANTED, OUR PAYMENT TERMS ARE NET 30 DAYS UNLESS OTHERWISE NOTED.
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Application for Credit:

Credit Application

Business Information

Credit References

Business References

Terms