Credit Application

Please fill out the form below to apply for credit with Radius Logistics. All required fields marked with an asterisk (*).

Click here to download a printable PDF version of this form.

Company Information
Company Name*
Address*
CIty*
Province/State*
Postal Code/Zip Code*
Contact Name*
Contact Number*
Email*
Re-type Email*
Fax
Website Address
Years in Business*
GST#/IRS#*
Legal Structure*
Accounts Payable Name*
Accounts Payable Phone #*
Bank Information
Bank Contact*
Bank Email*
Re-type Bank Email*
Bank Phone #*
Bank Fax #
Credit Limit Requested*
Invoice Currency*
Please provide a minimum of 2 Transportation references below:
Reference #1
Reference 1*
Phone #*
Fax #
Reference #2
Reference 2*
Phone #*
Fax #
Please provide a minimum of 2 Trade references below:
Reference #1
Reference 1*
Phone #*
Fax #
Reference #2
Reference 1*
Phone #*
Fax #
Radius Logistics Terms are Net 7 days. Past due accounts will be assessed a finance charge of 1.5% compounded daily. We certify the information contained herein to be true and correct. We agree to full payment of all invoices per Radius Logistics. terms. We understand that we may be liable for additional charges & costs of collection should our credit account become delinquent.
By Clicking this box you are submitting your digital signature*
Full Name*
Title*
Date*

Day
Month
Year