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Tools Tools Request Quote Express Check Customer Login Imaging System Online Claims Download Forms Fax-Email Payment Secure Payment Online Credit Printable Credit		Credit Application Required fields are marked with an * asterisk. Shelba D. Johnson Trucking, Inc. Contact Name*:     Line of Credit Requested*:     Business Information Business Name:  Phone:  FAX:  Registered Company Address:  City:  State:  Zip:  How long at this address:     Email Address:  Billing Address if different:  City: State:  Zip:  Delivery Address if different:  City: State:  Zip:  DBA:     Federal Tax ID:  Type of Business:  Date Established:  Does State, County, or City require a license?  YesNo If yes, License #:  Number of Employees:     Estimated Annual Sales:     Sales Area: Business Ownership Ownership:    SoleProprietorshipPartnershipCorporationSCorpLLC   Principal Name:      Title:      SSN:  Home Address:    Principal Name:  Title:  SSN:  Home Address:  Bank and Debt Information Bank Reference:    Contact:  Phone:  Address:  City:     State: Zip:  Type of account  Account number Savings Checking Other Has the Company or any of its Principals ever files for bankruptcy:    Yes No If yes, explain:  Mortgage Holder/Landlord:  Address:  Phone:  Other Business Debts Name:     Address:     Phone:  Name:  Address:  Phone:  Name:  Address:  Phone:  Business/Trade References Company Name:  Contact:  Address:    City:    State:    Zip:  Phone:    FAX:    Email:  Type of account:    Company Name:  Contact:  Address:    City:    State:    Zip:  Phone:    FAX:    Email:  Type of account:    Company Name:  Contact:  Address:    City:    State:    Zip:  Phone:    FAX:    Email:  Type of account:  Agreement Applicant agrees to pay any collection costs incurred to collect the outstanding balance on all accounts, including attorney’s fees. Applicant concurs with Shelba D. Trucking, Inc Tariff The undersigned      Will Will Not      submit a Financial Statement The undersigned as an inducement to grant credit warrants that the information submitted is true and correct. You are authorized to investigate the credit references listed above. Signatures      Name Title       Name Title       Name Title       Name Title  Personal Guarantee In consideration of credit being extended by Shelba D. Johnson Trucking, Inc. to the above named applicant for deliveries to be made whether applicant be an individual or individuals, a proprietorship, a partnership, a corporation, a S-corporation, or other entity, the undersigned guarantor or guarantors each hereby contract and guarantee to Shelba D. Johnson Trucking, Inc. the faithful payment, when due, of all accounts of said applicant for deliveries made within five years after the date of this application. Any revocation of this guarantee shall be in writing and delivered to Shelba D. Johnson Trucking, Inc., P.O. Box 7287, High Point, NC 27264.      Name Title       Name Title       Name Title       Name Title