Credit Application for Fleet Wash Account

Name of Applicant *

First

Last

Title *

Company Name *

Phone *

Fax

Email *

Registered Company Address *

Address Line 1

Address Line 2

City

State

Zip Code

Date Business Commenced *

Legal Entity? *

Primary Business Address *

Address Line 1

Address Line 2

City

State

Zip Code

How long at current address?

Phone *

Fax

Email *

Bank Name *

Bank Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Type of Account *

Account Number *

Company Information 1

Company Name 1 *

Address 1 *

Address Line 1

Address Line 2

City

State

Zip Code

Phone 1 *

Fax 1

Email 1 *

Company Information 2

Company Name 2

Address 2

Address Line 1

Address Line 2

City

State

Zip Code

Phone 2

Fax 2

Email 2

Company Information 3

Company Name 3

Address 3

Address Line 1

Address Line 2

City

State

Zip Code

Phone 3

Fax 3

Email 3

Read & Select All to Show Acknowledgement *

All invoices are to be paid 21 days from the date of the invoice.
Claims arising from invoices must be made within 7 working days.
By submitting this application, you authorize Semi Crazy Truck Wash, LLC to make inquiries into the banking and business/trade references that you have supplied.

Signature *

Clear Signature

Today's Date *

16136 E Admiral Pl, Tulsa, OK 74116

(918) 978-0779

Credit Application for Fleet Wash Account

Company Information 1

Company Information 2

Company Information 3

Contact Info

Useful Links

Our Location