Secure Online Form

Credit Application

Complete the form below to apply for a credit account with Amtrix Global Freight.
All information is encrypted and reviewed within 2 business days.

I have a pre-prepared credit packet.

Customers with a complete credit packet may check this box, skip the form, and upload documents below.

AGF Agent / Sales Person

Contact Information

Legal Name of Business

DBA Name

Date of Incorporation

State of Incorporation

Officer Name

Officer Title

Officer Phone

Officer Email

Street Address

Address Line 1

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Accounts Payable

A/P Contact

A/P Email

A/P Phone

A/P Fax

Business Details

Type of Entity

Type of Business

Years in Business

Federal ID #

D & B #

No. of Employees

Annual Revenue

Billing Information

Billing Company Name

Address Line 1

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Billing Contact

Billing Email

Billing Phone

Email for Sending Invoices

Banking & Credit References

Bank Name

Bank Officer

Bank Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Bank Contact

Years of Relationship

Bank Phone

Bank Email

Account #

Trade Reference 1

Creditor Name

Creditor Contact

Creditor Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Years of Relationship

Creditor Phone

Creditor Email

Upload Documents

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PDF, DOC, XLS, JPG, PNG, ZIP — up to 10MB each

Consent. * We understand and will comply with regulations requiring payment of all freight charges within thirty (30) days of receipt of statement.

By submitting you confirm the information provided is accurate.

Credit Application

Credit Application

Contact Information

Street Address

Accounts Payable

Business Details

Billing Information

Banking & Credit References

Trade Reference 1

Upload Documents

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