FIRST PARISH TRANSPORTATION CORP. D/B/A/ YELLOW CAB
6057 PINO STREET, BATON ROUGE, LA. 70806-1222

COMMERCIAL ACCOUNT - CREDIT APPLICATION
 
Name of Business
Physical Address   Suite:
Mailing Address:
City:
State:
Zip:
Telephone (1):
Telephone (2):
Facsimile:
Contact Person:
Telephone: Ext. Number:
Contact Email Address:
Website Address:
Taxpayer ID (EIN):
Organizational Type:
Proprietorship Partnership Corporation Government Non Profit
Business Information
Dun & Bradstreet
number:		 Stock name/symbol:
President: Vice President:
Secretary: Treasurer:
Incorporated in
State of:		 Date of
Incorpoation:
If Partnership or Proprietorship:
Authorized Persons
Persons Authorized to approve the use of services to be rendered on open account:
Purchase
Information
Is there a Purchase Order number required? If so please enter.   
Is there a Voucher number system required? If so please enter a description below of any required information
Bank Reference
Name of
account holder:
Bank Name:
Branch:
Address:
Account Number:
Credit Reference 1
Name:
Branch:
Address:
City:     Zip:    
Account Number:
Contact Name:
Telephone:    Ext. Number:
Credit Reference 2
Name:
Branch:
Address:
City:     Zip:    
Account Number:
Contact Name:
Telephone:    Ext. Number:
Credit Reference 3
Name:
Branch:
Address:
City:     Zip:    
Account Number:
Contact Name:
Telephone:    Ext. Number:
Credit Reference 4
Name:
Branch:
Address:
City:     Zip:    
Account Number:
Contact Name:
Telephone:    Ext. Number:

We hereby authorize First Parish Transportation Corp. dba Yellow Cab to request from any source and authorize the release of, any information pertaining to our credit history or any other pertinent information.

 

WE UNDERSTAND AND AGREE TO THE FOLLOWING TERMS IF CREDIT IS APPROVED:

All charges appearing on all invoices and statements will be paid in full by the twentieth (20th) of the month in which the bill is received. Any disputed charges must be addressed to the company in writing within twenty (20) days of the statement date, otherwise all are assumed to be correct and due in full. You remain obligated to pay all charges not in dispute on time. Accounts not paid in full by the time of the next billing cycle will be assessed a late penalty of 1.65 % per month (19.8% annually) on the balance to defray the additional accounting costs incurred. Should collection become necessary, you agree to pay any and all reasonable attorney and or collection fees as set by the Court. Failure to restrict the use of the account by listing “PERSONS AUTHORIZED TO APPROVE THE USE OF SERVICES TO BE RENDERED ON OPEN ACCOUNT” will result in the extension of any credit privileges granted to the applicant company, to also be granted to any person(s) or firm(s) representing themselves as an agent(s), employee(s), or principal of the applicant company. Furthermore if the account is not restricted, the applicant company waives any rights to dispute any charge on the grounds of unauthorized use.