Credit Application - Caprock Rentals

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Phone: (830) 360-9901

Email: sales@caprock-rentals.com

Address: 7039 FM 1044, St 402, Marion, TX 78155

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Credit Application

- Step 1 of 6

Company Information

Customer Legal Name *

Trade Name (DBA)

Physical Address *

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Website / URL

Layout

Federal Tax ID *

State Entity Formed *

Company Formation *

Years in Business *

Have you ever filed for bankruptcy? *

Yes
No

Are you a subsidiary / division? *

Yes
No

If answering "yes" please complete the following.

Parent Company Name

Parent Company Phone

Parent Company Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent Company Website / URL

Accounting & Invoice Processing

Layout

Purchase Order Required *

Yes
No

Job Number Required *

Yes
No

AP Contact

Name *

First

Last

Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

How will you be paying? *

ACH Credit / Electronic Payment: Your company initiates payment to Caprock Rentals
Check Payment
Credit Card Payments: We accept VISA/MC/AMEX for invoices under $2,000.00. Additional fees may apply.

All invoices are subject to NET 30 terms. Invoices not pay within 30 days may be subject to a 1% per month charge.

Are you tax exempt? *

Yes
No

If you are tax exempt, please attached any necessary documents.

If you are tax exempt, please attached any necessary documents.

Click or drag a file to this area to upload.

Banking Information

Bank Name *

Phone *

Contact Name

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Trade Reference # 1

Trade #1 Name *

Layout

Account #

Year Opened *

Account Contact *

First

Last

Contact Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Trade Reference # 2

Trade #2 Name *

Layout (copy)

Account #

Year Opened *

Account Contact *

First

Last

Contact Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Signatory Information / Authorized Agent

Name *

First

Last

Title / Relation to Customer *

Phone *

Email *

Date / Time *

Date

Time

Signature *

Clear Signature

Headquarters

7037 FM 1044
Marion, TX
78124

Phone: (830) 360-9901

Email: sales@caprock-rentals.com

Private Security Contractor

Texas License #: B26262201

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