Credit Application Please enable JavaScript in your browser to complete this form.Name of Firm or Individual *Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeLayoutWebsiteEmail *FAXLayoutSocial Security No. or Federal I.D No. *Years in Business *Layout (copy)Years at this address *Phone # *Tax ExemptYesNoHEREBY 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 monthsPartnershipIndividualOwnershipName of Principal *Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeFaxName of PrincipalAddressAddress Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeFaxBanking InformationLayoutBank Name *Bank Address *LayoutBank Officer or DepartmentEmail *FAX *Trade/Credit ReferencesReference #1LayoutCompany Name *Complete Address *ZIP *LayoutContact Person *PhoneEmail *FAX *Reference #2Layout (copy)Company Name *Complete Address *ZIP *LayoutContact PersonPhoneEmail *FAX *Reference #3Layout (copy) (copy)Company Name *Complete Address *ZIP *Layout (copy)Contact PersonPhone Email *FAX *Reference #4Layout (copy) (copy) (copy)Company NameComplete AddressZIPLayout (copy) (copy)Contact PersonPhoneEmailFAXCheck 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. Signature *LayoutDate *Title * Complete if Tax ExemptWisconsin Department of Revenue Income, Sales, Inheritance & Excise Tax Division Post Office Box 8903 Madison, Wisconsin 53708 Certificate of ExemptionSingle PurchaseContinuousThe 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.Based upon his or her proposed exempt use of the item purchased or the exempt status of the purchasing institution as shown below. - more4. Items or services purchased directly and used by a religious, charitable, educational, scientific or other organization holding a Certificate of Exempt Status. CES No. Items or services purchased directly and used by a religious, charitable, educational, scientific or other organization holding a Certificate of Exempt Status. CES No. - more5. 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.8. Resale Certificate SP No. - moreIf “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 NameAuthorized SignatureLayoutPurchaser's AddressTitleDatePurchaser'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 Send Application