(If YES, you must attach exemption certificates with this form)
All statements made herein are true and accurate to the best of my/our knowledge. The above company and its agents are authorized to make a credit investigation and are hereby indemnified from any liability resulting from their credit
survey. I/we agree to pay a late charge of 15% per month (18% per year) or a $100 minimum on any delinquent balance.
I/we agree to pay reasonable attorney fees and costs if legal action is necessary to collect any sums due on this account or under the guarantee hereof. In the event that any legal action is required to collect on this account, venue for such
legal matters will be within the State of Texas. If you do not want us to share credit information about you, please submit that request in writing to: Pilot Thomas Logistics, 201 N Rupert St Fort Worth, TX 76107 Attn: Credit.
Notwithstanding that this account is established in the name of a company, I personally guarantee payment of
You are required to sign the enclosed W-9. If you require forms for exemptions, please contact your sales representative
directly, this application package will not apply. Your account will not be exempt from taxes.
This information must be provided to ensure your account is set up with the proper contact information.
Payment terms will come from seller’s credit department upon approval
(A signed statement or bonded user certificate is required otherwise not eligible to purchase)
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