BlackBall Logistics Customer Credit

Customer Credit Application

Submit customer account and credit information for BlackBall review. This application helps BlackBall evaluate billing setup, requested terms, tax exemption requirements, project support needs, and customer account readiness.

This application starts BlackBall’s customer credit review process. Submission does not guarantee approval, credit limit, payment terms, or account activation. BlackBall may request additional documents or a secure signature packet before approving credit terms.

Security note: Do not enter full Social Security Numbers, bank account numbers, or other highly sensitive personal information in this form. If required, BlackBall will request that information through a secure credit packet or signature workflow.

1. Company Information

Provide the legal customer information BlackBall will use for account and credit review.

Legal Company Name

DBA Company Name

Entity Type

State of Incorporation

Date Established

Years in Business

Federal Tax ID

Website

Company Description

2. Primary Contact

Provide the best contact for credit review and account setup.

Primary Contact Name

Job Title

Phone

Cell Number

Fax Number

3. Physical Address

Physical Street

Physical Street 2

City

State

Country

4. Billing Address

Provide billing address if different from the physical address.

Billing Street

Billing Street 2

Billing City

Billing State

Billing Country

5. Credit Request

Tell BlackBall the credit limit and account setup your organization is requesting.

Requested Credit Limit

Requested Payment Terms

Estimated Monthly Volume

Purchase order required Tax exemption required High priority review

6. Ownership / Authorized Officer

Provide the authorized officer or owner contact for credit review. Do not provide full SSN here.

Owner / Authorized Officer Name

Owner / Officer Title

Owner / Officer Telephone

Owner Date of Birth Only provide if required by your company policy and approved for this submission.

Owner / Officer Street

Owner City

Owner State

Owner ZIP

7. Business / Project Profile

Industry Type

Geographic Scope

Occupancy Status

Service Needs

Special Requirements

Government entity / government-funded project

UEI Number

DUNS Number

Contractor License Number

8. References and Supporting Documents

Bank Reference

Trade References

Upload Supporting Files Optional: signed credit form, tax exemption certificate, customer PO instructions, W-9, financial reference sheet, trade references, or project documentation.

Additional Notes

Submission creates a customer credit intake record for BlackBall review. BlackBall may follow up with a secure signature packet or additional document request.