Old Dominion Truck Leasing

Credit Application & Agreement

If you prefer, you may download the form and fill it out by hand.

Fax your completed application to:
(804) 275-7847

or mail it to:
Credit Application
Old Dominion Truck Leasing
Post Office Box 730
Chesterfield, VA 23832

* denotes a required field

*Legal Company Name:

*Mailing
Address:

City

State

Zip

*Street
Address:

City

State

Zip

*Phone:

*Fax:

*Tax ID or Social Security #:

*Type of Business: Corporation Partnership Sole Proprietor

*Annual Income:

*Years in Business:

*Principal Business Activities:

Name of Owners, Partners, or Officers

*Name:

*Title:

*Email:

Name:

Title:

Email:

Dunn & Bradstreet # :

Bank Name:

Account #:

Contact Name:

Phone #:

Other persons authorized to charge to this account

Are PO Numbers required? :

Please fax a copy of your most recent financial statement to: (804) 275-7847

AGREEMENT

Our billing terms are net fifteen (15) days. Any invoice that remains unpaid beyond thirty (30) days is subject to a finance charge of 2% per month (24% APR). If not paid within thirty (30) days, convenience of the account may be suspended or account privileges withdrawn until the account is paid in full.

In the event that Old Dominion Truck Leasing, Inc., must take legal action to collect this account, I agree to pay reasonable attorneys' fees, thirty-three per cent (33%) of the outstanding balance, court costs, sheriff's fees and bond costs incurred by Old Dominion Truck Leasing, Inc.

I certify that all of the information on this application is correct, and give Old Dominion Truck Leasing, Inc., permission to make any inquiries.

Applicant's Name:
Applicant's Title:
Date:

Home | Services | Used Equipment
Employment | Contact Us | Credit App