Apply for Credit SERVICES APPLY FOR CREDIT Credit Application FIRM NAME BRANCH OFFICES BILLING ADDRESS CITY STATE (None) Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP STREET ADDRESS CITY STATE (None) Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP PHONE FAX EMAIL Account Payable CONTACT PHONE EMAIL TYPE OF BUSINESS TYPE OF OWNERSHIP Partnership Limited Liability Corporation (LLC) Sole Proprietorship Corporation FEDERAL TAX ID # YEAR BUSINESS ESTABLISHED DUN & BRADSTREET AFFILIATE COMPANIES Corporate Principals/Partners/Owner FULL NAME TITLE FULL NAME TITLE Credit References - Please list three truckload carrier credit references that you have done business with at least one year. CREDITOR PHONE CITY STATE (None) Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming CREDITOR PHONE CITY STATE (None) Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming CREDITOR PHONE CITY STATE (None) Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Financial Information BANK CITY STATE (None) Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming PHONE OFFICER Credit Application Terms 1. If Invoice payment is not received by Swan Transportation Services, LTD. (“Broker”) within thirty (30) days of the invoice date, the undersigned (“Shipper”) shall pay a finance charge of one and one-half percent 1 ½ % monthly(annual percentage rate of 18% on all unpaid amounts, less credits and unpaid finance charges from the date of the invoice. The finance charge shall in no event exceed the maximum rate which is permitted by law. In the event, any finance charge exceeds that which is permitted by law, any such excess shall be deemed a mistake and the excess shall, at the option of Broker, either be refunded to Shipper or credited to the unpaid balance of the account. 2. “Broker agrees that in the transportation of CLIENT(S) shipments, it assumes secondary liability in the event that a valid claim is not paid by the motor carrier, as provided by 49 U.S.C 14706 and the cases as promulgated thereunder. Carrier shall be responsible for the primary liability (BROKER as secondary) for the full actual loss value of the goods lost or damaged, up to the maximum of $100,000, unless such greater limit of liability has been agreed to in writing by BROKER prior to the tender by CLIENT of any individual shipment.” 3. THIS AGREEMENT SHALL BE GOVERNED BY, CONSTRUED AND ENFORCED IN ACCORDANCE WITH THE LAWS OF THE STATE OF TEXAS. THIS AGREEMENT AND ALL OBLIGATIONS ARISING HEREUNDER SHALL BE DEEMED TO BEPERFORAMABLE IN TYLER, SMITH COUNTY, TEXAS. The parties agree and consent to the exercise of jurisdiction by the courts by the courts of Smith County, Texas to determine any dispute relating to this agreement, performance hereunder, or any asserted breach hereof. No provision of this agreement shall be modified or limited except as agreed to in writing by the parties hereto. If any provision shall for any reason be or become invalid or unenforceable, the remainder shall not be affected hereby. 4. This agreement cannot be modified, amended, limited or suspended unless in writing and signed by Broker. This agreement together with the invoices and any Shipper/Broker Transportation Agreement between the parties (the “Transportation Agreement”) constitute the entire agreement of the parties. No agreements, representations or warranties other than those in this agreement and contained in the body of the invoices shall be binding unless made in writing and signed by both parties. In the event of any conflict between these Credit Application Terms and the Transportation Agreement, the terms of the Transportation Agreement shall control. I (we) fully understand these terms and agree to the proper payment in consideration of the services to be rendered by Broker and the extension of credit. NAME OF COMPANY APPLYING FOR CREDIT NAME AND TITLE OF COMPANY REPRESENTATIVE You may withdraw your consent to receive electronic documents, notices or disclosures at any time. In order to withdraw consent, you must notify Swan Transportation Services that you wish to withdraw consent and request that your future documents, notices and disclosures be provided in paper format. The parties agree that this agreement may be electronically signed. The parties agree that the electronic signatures appearing on this agreement are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility. SIGNATURE OF COMPANY REPRESENTATIVE CLEAR UNDO SUBMIT linkedin facebook twitter BECOME AN AGENT REQUEST A QUOTE © 2021 SWAN TRANSPORTATION · POWERED BY THE A GROUP