| Company Information |
Company Name |
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Principal Name |
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Principal Title |
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Street Address |
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City |
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State |
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Zip Code |
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Phone |
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Fax |
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Company Type |
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Nature of Business |
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Date Established |
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Type of Cargo |
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Amount of Credit |
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Pursuant to the date of this submission, I have been advised that Triton Overseas Transport's standard credit terms are payable in full within twenty-one (21) days of the shipment date. By checking the box below, I signify that: |
|
|
within
days. |
Business References (supply three references) |
Company One |
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City and State |
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Contact Name |
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Contact Phone |
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Email |
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Company Two |
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City and State |
|
Contact Name |
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Contact Phone |
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Email |
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Company Three |
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City and State |
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Contact Name |
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Contact Phone |
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Email |
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Bank Reference |
Bank Name |
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Bank Address |
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Bank Officer |
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Bank Release and Consent |
I hereby authorize Triton Overseas Transport Inc. to obtain any credit reference they |
| might need for the purpose of establishing a line of credit with them. It is understood |
| and agreed that this is confidential information and is without liability on your part. |
I certify that the above information is true and correct to the best of my knowledge, |
and furthermore, I realize my obligation to inform Triton Overseas Transport, Inc. of any |
and all changes to the above information. |
Your Name:
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Your Title:
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| Your Email:
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