NOTICE: CAST Transportation has moved to a new host. As a result, we are upgrading all online web forms. These forms are not currently operational, however all changes should be complete by Wednesday March 5th. We apologize for any inconvenience.
Please use the printable version and FAX, mail, or email your request to CAST Transportation.
Thank you for your interest in CAST Transportation. This form can be filled in and delivered on-line, or click HERE for a printable version.
APPLICATION FOR CREDIT / TRANSPORTATION AGREEMENT


9850 Havana Street
Henderson, Colorado 80640-8443
Tel: 303-534-6376
Fax: 303-853-3377

*FED Tax ID #

If your Fed Taxpayer ID is a SS#, enter "00-00" and see Note 3 below

*State of Incorporation

•Be sure to complete ALL required fields (denoted by the red asterisk * ).
 •If you provide an email address, a confirmation will be sent to you upon successful completion.
•Upon completion, you may be asked to provide additional information. You should be prepared to provide:
- a Social Security number if you do not have a Federal Taxpayer ID Number
- a Financial Statement
SHIPPER/CONSIGNEE
Please Complete All Blanks		 If Shipper/Consignee is a corporation or has a prepared
financial statement, please be prepared to provide a copy.
Note: Use box I. at bottom to add more information.


*Business Name / Legal Responsibility


*Pro Name / DBA

*Address *City  *State *Zip Code



*Business Telephone Number

*Specify Company Type:

*Fax Number
OWNERS (If applicant is a sole proprietorship or partnership) - OFFICERS (If a corporation)

*Name


*Title
Name


Title


*Person to contact on credit matters
*How long in business
*At present location?

*Type of business		 *P.O. Required? YES  NO
*Monthly Credit Line


BANK REFERENCES

*Business: *Acct. No. *Phone: *Saving
Business: Acct. No. Phone: Checking Saving
Business: Acct. No. Phone: Checking Saving

TRADE REFERENCES

  *Name *Address *Phone *Balance Owing
*1.
2.
3.
4.


Credit Agreement
Shipper/Consignee agrees with Terms and Conditions, and agrees to pay for all services and labor provided by CAST within
15 days from the date of service. If not so paid, Shipper/Consignee also agrees to pay interest from the date of service at
the rate of 1 1/2% per month (Annual Percentage Rate 18%) in addition to reasonable costs of collection, including attorney
fees. Exclusive jurisdiction and venue for any litigation relating to or arising from this Agreement or for services and labor
provided hereunder shall be in the courts of Adams County, Colorado.

  Dated this:    14th day 2008f May, 2008     
  *By:  
  *Title:  
  *Email  
*Optional - Enter E-mail address if you want to receive Confirmation Notification(s).

 

I. Use this box for additional information or to elaborate on any item(s) above.

 

 
 
*ELECTRONIC SIGNATURE:
By checking this box I Certify that I have read the Terms and Conditions and that the above information is accurate, complete, and true.    
 
(Note: Upon approval, a signed copy may need to be submitted.)

 

   


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