Business Details

Responsible Party

Billing Address

Physical Address

AP Contact Details

Vehicle Information

PO Required?


IF YES...

Ownership

Bank/Branch

Local Trade References

How did you hear about us?

Upload Sales Tax Exemption Or Reseller Certificate

Upload Business License


AGREEMENT: As an authorized agent of the business applying for credit (hereinafter “applicant"), I understand this credit application authorizes Express Oil Change, LLC, dba Express Oil Change & Tire Engineers, to check all credit and business associations of applicant. Furthermore, I understand that if applicant is granted credit, the following agreements are made in consideration of that extension of credit:

  1. All purchases will be paid for in accordance with terms of sales
  2. If applicant fails to pay for said purchases when due, the applicant agrees to pay and authorizes the assessment of interest charges of 1.5% per month (18% per annum) on any past due amounts.
  3. In the event a lawyer or collection agency is used to collect a delinquent account, applicant understands and agrees to pay all collections costs including court costs, fines, and reasonable attorney’s fees.

By entering your name, you are agreeing that you are digitally signing this document and you are guaranteeing the payment of services. Additionally, you are indicating that you are authorized to sign on behalf of your company, i.e., an officer or owner of the company.

Authorized to sign for the company as its: