Welcome to Fleet Safety Equipment

Note: If you are a government owned entity, simply fax a copy of your letterhead to (901) 377-5633 and you are approved. This form is for non-government owned businesses seeking credit approval. We require a minimum of 6) Credit References to begin the credit approval process

 

Credit Application
Company Name:
Address:
City, State, Zip:
Email:
Phone No:   Fax No: 
Kind of Business:
Select One: Individual: Partnership: Corporation:
 
 
References: Bank - Name:
Address:
 
 
Credit References: 1. Name:
Customer No:
Address:
Phone: Fax No: 
2. Name:
Customer No:
Address:
Phone: Fax No: 
3. Name:
Customer No:
Address:
Phone: Fax No: 
4. Name:
Customer No:
Address:
Phone: Fax No: 
5. Name:
Customer No:
Address:
Phone: Fax No: 
6. Name:
Customer No:
Address:
Phone: Fax No: 
 
 
Sales Tax Status: Taxable:
Resale: (Certificate Will Be Requested)
Exempt: (Certificate Will Be Requested)
 
 
 I understand that Fleet Safety Equipment Inc's payment terms are "NET 30" and agree to pay according to those terms
 
Accounts Payable
Contact:		 Name:
Phone: Fax: 
 
 
Statements Sent By Request.
I do require a monthly statement:
I do not require a monthly statement:
 
 
When Completed, Print Page and Fax to 901-377-5633. Thank You! and We look forward to serving you!