Company: Type of Business:
Address: How long in business?                    
  Amount requested (U.S. Currency) $
City:

Contact Name:

State: Zip:

Title:

How would you like to be contacted?
Email:
Other: 
Telephone incl. area code: Fax incl. area code: 

Ownership: Corporation  LLC  Partnership  Sole Owner  Other: 
Principal Name: Title:

TRADE REFERENCES:
Name: Address:
City: State: Zip:
Telephone:  
Name: Address:
City: State: Zip:
Telephone:  

BANK REFERENCES:
Name: Address:
City: State: Zip:
Telephone: Acct#
Name: Address:
City: State: Zip:
Telephone: Acct#

Export Credit Agreement. Applicant agrees to pay any collection fees incurred to collect the account balance, including reasonable attorney's fees and interest. Standard export payment terms are net 15 days from date of invoice, unless noted otherwise in the confirmation letter. No credit will be granted until it is confirmed by us.
The applicant, as inducement to grant credit, warrants that the information submitted is true and correct. By clicking on the "Submit Form" button, Seajet Express Inc. is authorized to investigate the credit and bank references above.