ANPAK Logistics & Transportation Solutions
#505-8840-210th Street, 
      Box 351, Langley, BC V1M 2Y2 Phone 604-888-0194 Fax 604-882-2966
Credit Application
Date:__________________________
Full Commercial Name:__________________________________________
Complete Mailing Address__________________________________________
City: ________________________Prov/State: ________Postal/Zip Code: _____________
A/P Contact: _____________________
Phone:_________________ Fax: ___________________ Email: _____________________
Cheques issued at (if different): ________________________________________________
City: _________________________ Prov/State: _______ Postal/Zip Code: _____________
Contact: ________________________ Phone: ________________ Fax: _______________
Nature of Business: _________________________________ For how long? ____________
REFERENCES:
Bank: _______________________________________________
Branch Address: ____________________________________________________________
Phone: ________________________ Contact:____________________________________
Trade (please include at least 3 transportation companies with phone numbers):
1: ________________________________________________________________________
2: ________________________________________________________________________
3: ________________________________________________________________________
4: ________________________________________________________________________

TERMS: Applicant agrees that, should credit be granted by ANPAK Logistics & Transportation Inc., all invoices from ANPAK will be paid in full within 30 days of receipt.
 
Authorized Signature: ______________________________ Title: ___________________