All Roads Express Credit Application

Legal Business Entity Name *

Business Trade Name or DBA (Doing Business As)

Business Address *

Address Line 1

Address Line 2

City

State

Zip Code

Principal Owner *

Your Full Name *

Must be authorized representative.

Your Email *

Your Title *

_

Your Phone *

Federal Tax ID

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Any Additional Comments for All Roads

Terms and Conditions *

By submitting this Credit Application, I agree to the following Terms and Conditions: *

I represent that the above information included in this Credit Application is true, correct, and complete. and that an online submission of this agreement shall be as binding as an originally signed and delivered document. A decision to grant or deny business credit requested of any company on this Credit Application will be made by All Roads. We may, in our sole discretion, refuse to extend business credit, goods, or services to you.

I authorize All Roads to obtain a business consumer credit report in order to further evaluate the credit worthiness of the applicant as principal(s), proprietor(s) and/or guarantor(s) in connection with the extension of business credit as contemplated by this Credit Application.

I as (an) authorized individual(s) hereby knowingly consent to the use of such credit report consistent with the Federal Fair Credit Reporting Act as contained in 15 USC 1681 ct seq. should All Roads agree to be bound to the terms of this agreement.

I acknowledge that I have read and fully understand the terms and conditions contained in this Credit Application.