Account Application

General Company Information

Company Name:

Street Address:

City/State/ZIP Code:

Phone Number:

Accounts Payable Phone:

Billing Address:

Owner's Name:

Manager's Name:

Type of Business:

Years in Business:

Date Incorporated:

TIN:

Credit Reference Information:

Name:	Name:
Address:	Address:
Phone:	Phone:
Credit Limit Desired:	Credit Limit Approved:
Name:	Name:
Address:	Address:
Phone:	Phone:
Credit Limit Desired:	Credit Limit Approved:

Bank Information:

Name:	Branch:
Phone:	Account #:

Please complete and fax back to Jet Delivery Systems, Inc. at (503) 256-2975.

Payment due in 30 Days

Applicant Signature

Jet Approval Date

Jet Form 960708 (Revised March 31, 2008)