CreditApp | R+L Carriers

Credit Application

All fields and sections are required unless they are noted as optional.

For the convenience of non-customers wishing to establish an account with R+L Carriers, an online credit application has been provided. Upon submitting the completed application, it will be reviewed by our staff who will respond to you by email.

You may also print a Credit Application and mail or fax it to R+L Carriers. Download the PDF credit application.

Company Information

Business Name

State Of Incorporation

Years in Biz.

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Ext.

Fax Number

Email Address

Industry Type

Type of Biz.

Annual Sales ($)

Credit Limit Req. ($)

DUNS

Officer's Name

Officer's Title

Officer's Name

Officer's Title

Billing Information

Same As Company

Name

Contact Name

Address Line 1

Address Line 2

City

State

Zip Code

Accounts Payable Contact

Phone Number

Ext.

Fax Number

Email Address

Provide bill of lading with invoice

Yes

Provide delivery receipts with invoice

Yes

Credit Reference 1

Name

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Ext.

Fax Number

Email Address

Credit Reference 2

Name

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Ext.

Fax Number

Email Address

Credit Reference 3

Name

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Ext.

Fax Number

Email Address

Credit Reference 4

Name

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Ext.

Fax Number

Email Address

Banking Institution

Name

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

Ext.

Fax Number

Email Address

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Credit Application

Credit Application