Kenworth Truck Centres

Kenworth Account Application

Full Legal Name of Company *

Operating As (if different)

Director or Owner of Business

Last Name *

First Name *

Initial *

Billing Address (911, lot, conc. twp., if applicable) *

City *

Province *

Postal Code *

Phone No. *

Email *

Shipping Address (if different from above)

City

Province

Postal Code

Phone No.

Years in Business

Business Premises

Own

Rent

Home

Other/Explain

Banking Information

Bank

Account Manager

Account Number

Address

Phone No.

Principal Suppliers (Credit References Note: Fuel, Oil & Tire companies not acceptable.)

	Name	Phone	Fax/Email
1.
2.
3.

HST Number *

Account Type * C.O.D. Terms

Account Payable Contact *

Email (Accounts Payable) *

P.O.'s Required Yes No

Email Statements Yes No

Email Invoices Yes No

Select your Sales Representative *

Authorization:

The undersigned, hereafter referred to as the Applicant, authorizes Kenworth Toronto Ltd., hereafter referred to as Kenworth, to conduct or cause to be conducted a personal investigation of the Applicant or any principals thereof with a view to determine the credit reliability in support of this Application For Credit and consent to the disclosure of such information.

Kenworth is authorized to periodically deliver a statement of account to the Applicant at the address stated herein, or to such alternate address as may, from time to time be specified in writing by the Applicant. The Applicant, or a representative of the Applicant, must notify Kenworth in writing of any errors, irregularities or omissions therein, within thirty (30) days from the date of such statement failing which the balance shown owing on such statement shall be finally and conclusively settled and agreed as between Kenworth and the Applicant.

This Application for Credit is made with the understanding, and agreement, that all charges for parts and service work are due and payable in full on receipt of statement of account and that the balance shown as owing on such statement is subject to a late charge of 1.5% per month, 18% per annum, if unpaid by the 15th of the month following the date of such statement failing which the balance shown as owning on such statement shall be finally and conclusively settled and agreed as between Kenworth and the Applicant.

Signature *

Title *

By clicking on "Submit", I agree to be legally bound by the above terms.