Howells Motor Freight, Inc.
P.O. Box 12308
Roanoke, VA 24024		 Phone: (540) 966-3200
Fax: (540) 966-3202
Confidential Credit Application
Business Name: Tax ID#:
Address: Invoices Paid: In-House Outside Company
Phone: Accts. Payable Contact:
My company is: Accts. Payable Address:
Type of Business: Accts. Payable Phone:
Date Established: Accts. Payable Fax:
Information Required on Billing:
Owners / Officers
Name: Title:
Address: Phone:
Name: Title:
Address: Phone:
Trade References
Name: Contact:
Address: Phone:
Name: Contact:
Address: Phone:
Name: Contact:
Address: Phone:
Bank References
Name: Contact:
Address: Phone:
Name: Contact:
Address: Phone:
Credit Terms and Agreement

Our terms are net payable within fifteen (15) calendar days of invoice. Any balance not paid within thirty (30) days will be subject to a 2% service charge (annual percentage rate of 24%) on the delinquent balance. Your account will be assigned a maximum credit limit, subject to periodic review, and should your unpaid balance exceed this limit, you will be required to make payment on your account prior to the shipping date until your balance is within your credit limit. The applicant hereby authorizes Howell's Motor Freight, Inc. to obtain credit information needed to process this application. The applicant agrees to pay attorney's fees and/or collection agency fees arising from the collection efforts of Howell's Motor Freight should the account become delinquent. In the event this account is in dispute, venue will lie in the county of Botetourt, Virginia.


By submitting this form you certify that the above information is correct, you authorize the release of credit information relevant to the above account to Howells's Motor Freight, Inc. and you understand and agree to the terms listed above. This constitutes a legally binding electronic signature under the United States ESIGN Act.