New Account Application-Net 30

Company Information

Company Name *

Your Name *

First

Last

Phone Number *

Email Address *

Company Address *

Address Line 1

Address Line 2

City

State

Zip Code

Year Business Started *

Organization Type *

Corporation
Partnership
Sole Proprietorship
Government

Tax I.D. Number *

Dun & Bradstreet D‑U‑N‑S Number

Is the above Company Address also the primary shipping address? *

Company Shipping Address *

Address Line 1

Address Line 2

City

State

Zip Code

Are you the primary shipping contact person? *

Primary Shipping Contact Name *

First

Last

Primary Shipping Contact Phone *

Primary Shipping Contact Email *

Billing Information

Are you the primary Billing contact person?

Billing Department Name or Contact Person

Billing Contact Phone Number

Is your Company Address also the Primary Billing Address? *

Billing Address

Address Line 1

Address Line 2

City

State

Zip Code

What is your Invoice/Billing Email Address? We will send PDF invoices to this email address *

Confirm Email

Is a PO # / Cost Center / Reference Number required with your shipments? (Optional)

If you answered Yes to the above question, please tell us what information you require for each Shipment

Terms and Conditions

Billing Frequency: Each 15th and End of Month *

I agree to the Billing Frequency listed above

Payment Terms: Net 30 days. Any unpaid balance will incur an additional interest charge of 1.5% per month *

I agree to the Payment Terms listed above and understand that I am responsible for paying interest charges if payment is not submitted by the invoice due date

Shipping Terms and Conditions can be reviewed at:

Smart Delivery Service's Terms and Conditions (https://smart-delivery.com/terms-and-conditions/)

Have you reviewed Smart Delivery's Shipping Terms and Conditions by clicking the link above? *

I have reviewed and agree to the Terms and Conditions at the above link

By clicking the "Yes, I agree" checkbox below, you certify that the provided information is correct, you agree to the Billing & Payment Terms, you authorize Smart Delivery Service to check your business credit report, and you have the authority to enter into a shipping agreement on behalf of your organization *

Yes, I agree

Using your computer mouse, please sign your name below *

After completing the above questions, click on the Submit button below.

Smart Delivery Service Dallas – Minneapolis

The Smart Courier Choice since 1989

New Account Application-Net 30

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Houston, TX

Dallas/Fort Worth, TX

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