Credit Application Name of Firm or Individual Address City State ZIP Website E-Mail Address FAX Social Security No. or Federal I.D No. Years in Business Years at this address Phone # Tax Exempt? YesNo HEREBY applies for credit in accordance with the terms and conditions of Truck Equipment, Inc. The following information must be provided. It will be held in the strictest of confidence CorporationCheck here if incorporated within the past 12 monthsPartnershipIndividual OWNERSHIP Names of Principal Complete Address ZIP Phone FAX Names of Principal Complete Address ZIP Phone FAX BANKING INFORMATION Bank Bank Address Bank Officer or Department Email FAX TRADE/CREDIT REFERENCES Reference #1 Company Name Complete Address ZIP Contact Person Phone E-Mail Address FAX Reference #2 Company Name Complete Address ZIP Contact Person Phone E-Mail Address FAX Reference #3 Company Name Complete Address ZIP Contact Person Phone E-Mail Address FAX Reference #4 Company Name Complete Address ZIP Contact Person Phone E-Mail Address FAX Check here if cash sales are today until credit is approved. We certify that all the information on this form is correct. We fully understand your credit terms and agree to the proper payment in consideration of extended credit. I hereby authorize the above references and bank to release credit information to Truck Equipment Inc. (Signed) Date Title COMPLETE IF TAX EXEMPT Wisconsin Department of Revenue Income, Sales, Inheritance & Excise Tax Division Post Office Box 8903 Madison, Wisconsin 53708 CERTIFICATE OF EXEMPTION Single PurchaseContinuous The undersigned hereby claims exemption on the purchase, lease or rental of tangible personal property or taxable service form. (Name of Seller or Lessor) Based upon his or her proposed exempt use of the item purchased or the exempt status of the purchasing institution as shown below. 1. Containers and other packaging, packing and shipping materials used to transfer merchandise to customers of the purchaser. 2. Tangible personal property becoming an ingredient or component part of an article of tangible personal property in any form destined for sale. 3. Trailers, or accessories, attachments, parts, supplies, materials and service on motor trucks, tractors and trailers which are used exclusively in common or contract carriage under Authority No. 4. Items or services purchased directly and used by a religious, charitable, educational, scientific or other organization holding a Certificate of Exempt Status. CES No. 5. Railway cars, locomotives and other rolling stock used in railroad operations, or accessories, attachments, parts, lubricants or fuel therefor. 6. Commercial vessels (and barges) of 50‐ton burden or over engaged in interstate or foreign commerce or commercial fishing, and accessories, attachments parts and fuel therefor. 7. Other purchases exempted by law. (State items and exempt use.). 8. Resale Certificate SP No. If “continuous” exemption is checked above, this certificate shall continue in force until revoked and shall be considered as part of each order given to the above named seller or lessor. Use of this certificate does not exempt sales of taxable items for uses other than certified above. Misuse of this certificate by the seller, lessor, buyer, lessee, or other representative may constitute a misdemeanor. Purchaser's Business Name Authorized Signature Purchaser's Address Title Date Purchaser's or Lessee's Business Activity (e.g. Grocer, Utility, Trucker, etc.) This form is not to be used by farmers, or manufacturers purchasing machinery and equipment; they should use the exemption forms designed for their use. Sellers must retain this form as a part of their records. This Form May Be Reproduced
