Credit Application

"*" indicates required fields

Company Information

MM slash DD slash YYYY
Are you a corporation?*
Address of chief corporate officer 1*
Address of chief corporate officer 2*
Address of chief corporate officer 3*
Address of your resident agent*


Address of partner*

Sole Proprietorship

Are you sales tax exempt?*
Have you ever had credit with us before?*
Purchase order required?*

Trade Reference 1


Trade Reference 2


Trade Reference 3


Bank Reference 1


Bank Reference 2


General Terms and Conditions & Personal Guarantee

  1. Bills are sent as railway services are performed and all bills are payable in full 15 days from the billing date.
  2. A service charge of 1% per month will be added to all amounts billed if not paid by the 15th day from billing date.
  3. No additional credit will be extended to past due accounts unless satisfactory arrangements are made with our credit department.
  4. PERSONAL GUARANTEE: If the credit customer is a corporation, then those signing this application, whether signing as an officer or not, personally guarantee payment for all items purchased on credit by the corporation.
Agreement of Terms and Conditions*
I have read the terms and conditions stated above and agree to all of these terms and conditions.

Digital Signature

I represent that the above information is true and is given to induce credit to the applicant. My company and I authorize the Louisville & Indiana Railroad to make such credit investigation as sees fit, including contacting the above trade references and banks and obtaining credit reports. My company and I authorize all trade references, banks, and credit reporting agencies to disclose to the Louisville and Indiana Railroad any and all information concerning the financial and credit history of my company and myself.
MM slash DD slash YYYY
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