CREDIT APPLICATION FORM FOR AGENTS

CORPORATE INFORMATION

Legal Corporate Name*

Street*

City*

State / Province*

Postal Code*

# of Year in Business*

Telephone*

LEGAL REPRESENTATIVE

Full Name*

Email*

ACCOUNTING REPRESENTATIVE

Full Name*

Email*

BANK INFORMATION

Bank Name*

Branch Number*

Account Number*

Account Officer*

Telephone*

Fax

Email*

CREDIT REFERENCES

Agents worldwide that grant you credit

AGENT 1

Agent Name*

Contact*

E-mail*

Phone*

AGENT 2

Agent Name*

Contact*

E-mail*

Phone*

AGENT 3

Agent Name*

Contact*

E-mail*

Phone*

ARE YOU PART OF FREIGHT FORWARDING ASSOCIATIONS?*

YES

NO

Association #1*

Since when*

Association #2

Since when

Association #3

Since when

CREDIT VERIFICATION

I hereby authorize Latin American Cargo to undertake necessary credit investigations. I hereby adhere to the terms and conditions of payments as granted by Latin American Cargo and acknowledge that credit privileges may change at the discretion of Latin American Cargo.

Full Name*

E-mail*

Job Title*

Date*

(Max. 10mb - Allowed files: jpg, jpeg, png, gif, doc, docx, ppt, pptx, pdf, xls, xlsx)

Check here means that you accept our terms and conditions (see below*)

* TERMS & CONDITIONS

When appointed as a local agent, Latin American Cargo acts solely on behalf of the foreign agent hiring third parties that offer services such as carriage, storage, packing or handling of any goods, cargo insurance and any other service related to the transportation and logistics industry.

The foreign agent accepts to pay all services rendered in accordance to the terms established regardless of any shipment delays, bookings being rolled, cargo losses or cargo damages. All claims related to any of these occurrences must follow the regular legal course.

CREDIT APPLICATION FORM FOR AGENTS

PLEASE PROVIDE THE INFORMATION BELOW

CORPORATE INFORMATION

LEGAL REPRESENTATIVE

ACCOUNTING REPRESENTATIVE

BANK INFORMATION

CREDIT REFERENCES

AGENT 1

AGENT 2

AGENT 3

CREDIT VERIFICATION

Don't Just Take Our Word for It