APPLICATION INSTRUCTIONS:

Credit will be extended from AA Wheel & Truck Supply, Inc. on the following terms:

1.   Our terms are net 10^th PROX., which means after receipt of  invoice, your
payment is due on or before the 10^th of the following month, and is considered delinquent beyond that date.
2.   Accounts over 30 days delinquent may be subject to credit hold.
3.   All past due accounts will bear interest at 18% per ANNUM.
4.   If your account is turned over to attorney for collection, you agree to pay reasonable attorney fees and collection costs.

*Downloadable Credit Application here

If you are human, leave this field blank.

Firm Name

Type of Firm *

Corporation

Proprietorship

Partnership

LLC

Location for which you are applying

North Kansas City

Omaha

Springfield

Street Address

City

Zip

Phone

Fax

Under Current Ownership Since

Sales Tax Exempt

Yes

No

State/Sales Tax #

Purchase Order Required

Yes

No

Back Orders Accepted

Yes

No

Name/Address of Proprietor, Partners or Officers Name/Title/Address:

If Proprietor or Partner, Give SSN and DOB

Bank Name *

Checking Account # *

Bank Phone

Reference 1

Reference 2

Reference 3

Payment of this acct is personally guarenteed by

Today's Date

Additional Comments