Tripletplus commercial fleet roadside assistance credit application ph 1-844-888-7587 for commercial vehicles, trucks, trailers, semi trucks, bus and RV

1. TripleTPlus™ LLC
CREDIT APPLICATION AND AGREEMENT
Please complete the following information and return this form to TripleTPlus™ LLC, PO BOX 5844
Sherman Oaks, CA 91413, or FAX to 310-499-9268.
BUSINESS INFORMATION
BUSINESS NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE NUMBER: TAX ID#:
ACCOUNTS MANAGER:
BUSINESS LICENSE #:
RESALE # (IF APPLICABLE): (Please include a copy of your resale certificate with this application)
OWNERSHIP INFORMATION (check and complete appropriate section)
 Corporation State: Date Incorporated:
Officers: President:
Vice President:
Secretary:
Treasurer:
Soc. Sec. #
Soc. Sec. #
Soc. Sec. #
Soc. Sec. #
 Partnership Formed: Date:
Partner:
Partner:
Soc. Sec. #
Soc. Sec. #
 Sole Proprietorship Date Established:
Owner: Soc. Sec. #
OPEN ACCOUNT CREDIT REFERENCES:
NAME:
ADDRESS:
PHONE:
FAX #:
CITY: STATE: ZIP: ACCOUNT #:
NAME:
ADDRESS:
PHONE:
FAX #:
CITY: STATE: ZIP: ACCOUNT #:
NAME:
ADDRESS:
PHONE:
FAX #:
CITY: STATE: ZIP: ACCOUNT #:
PO BOX 5844 Sherman Oaks, CA 91413, or FAX to 310-499-9268. PH 844-888-7587

2. BANKING INFORMATION
BANK NAME & ADDRESS:
PHONE NUMBER: CHECKING ACCOUNT #
BANK OFFICER NAME:
FLEET INFORMATION
PLEASE LIST THE NAMES OF EMPLOYEES WHO ARE AUTHORIZED TO HAVE VEHICLES SERVICED AT
TripleTPlus™ AS WELL AS THE VEHICLES WHICH WILL BE COVERED UNDER THIS AGREEMENT. ATTACH
ADDITIONAL SHEETS AS NECESSARY.
EMPLOYEES:
VEHICLES:
MAKE/MODEL/YEAR
MAKE/MODEL/YEAR
MAKE/MODEL/YEAR
MAKE/MODEL/YEAR
VIN#
VIN#
VIN#
VIN#
Please note on separate maintenance schedule forms the specific requirements for each vehicle, if applicable.
BILLING INFORMATION
All payments are due on the 10th
of each month for parts purchased and service performed the previous month.
SIGNED: DATE:
PRINT NAME: TITLE:
PROPRIETOR GUARANTY AND AUTHORIZATION
I agree that any credit advance to the business named on this application is herewith personally guaranteed by me and that this guaranty shall continue so
long as credit is requested by the business by placing orders on this account and until TripleTPlus™ receives written notice of termination of my guaranty.
Such termination shall not change my personal liability for any credit, interest, charges or fees arising from credit extended prior to the actual receipt of such
Notice of termination by TripleTPlus™. I agree to pay all charges, interest, attorney’s fees and costs incurred in enforcing the terms of this guaranty. I agree to
waive any notice of presentment, non-payment, protest or dishonor of any negotiable instruments that may arise out of the execution of this extension of credit. I
Agree to waive any right to security and agree that TripleTPlus™. Has a purchase money security interest in any and all items sold on credit pursuant to this
Application and may sell, encumber, compromise or dispose of any such security as it deems necessary without my consent.
By signing this Application, I authorize TripleTPlus™ or its agent to investigate my personal credit and financial records including my banking records. As
part of such investigation, I authorize TripleTPlus™ to request and obtain consumer credit reports on me in connection with the opening, monitoring, renewal
and extension of this and other accounts with TripleTPlus™ and the marketing of other products and services to me and my business by TripleTPlus™ I
further authorize TripleTPlus™ to share the information received from my consumer credit report with TripleTPlus™ affiliates and subsidiaries. If I request,
You will tell me whether my consumer credit report was requested and, if so, the name and address of the consumer reporting agency that furnished the report.
On behalf of the business in whose name this application is made, and for myself, I agree that any charge shall bear interest from the due date at the rate
of one and one-half percent (1½%) per month. All bills and accounts are due on the 10th day of the month following the month the charge was incurred. Title to
all goods sold shall remain in the name of TripleTPlus™ until full payment is received. Any and all disputes will be resolved under the laws of the State of
California. Furthermore, pursuant to the Community Property laws of the State of California, both applicant and spouse shall be responsible for repayment of
all
Credit advanced to the business named on the application herein.
DATE:
WITNESS:
BY:
Personal Guarantor/Applicant
BY:
Personal Guarantor/Applicant
Failure to make timely payments will cause the principals to be held liable for all outstanding debts as permitted by
law. Any unpaid balances due after a thirty (30) day period will be assessed late charges in the amount of 1.5% per
month (annual percentage rate 18%) unless other arrangements have been made in advance.
T r i p l e T P l u s ™ reserves the right to terminate the credit arrangement if an account remains unpaid for a period
of sixty (60) days. Should TripleTPlus™ prevail in any legal proceeding to collect any unpaid charges, the
responsible party agrees to pay TripleTPlus™ reasonable attorney’s fees and collection costs in that proceeding.