Credit Request Form

Apply for a Bolted Box credit account online. It takes about 10 minutes, and a PDF copy of your application lands in your inbox as soon as you submit.

Start the Form Call

Before You Start

Have this handy and the form goes quickly. Enter N/A for anything that doesn’t apply.

Have These Handy

Your Federal EIN or Tax ID
Your accounts payable contact and invoice email
Three trade references (required)
A bank reference (preferred, not required)
A W-9 or tax exemption certificate (optional upload)

Payment Terms

Standard payment terms are Net 10 days from the invoice date. All invoices go out electronically to the invoice email you give us. Bolted Box may charge interest of 1.5% per month (18% per year) on past due balances at its discretion.

Two Ways to Apply

Fill everything out online, or download the PDF version, complete it, and upload it at the end. Already have documents that cover a section, like a credit reference sheet? Skip that section and upload them instead.

Credit Request Form

Get Started

This form applies for a credit account with Bolted Box, LLC, so you can pay by check, ACH, or wire on Net 10 terms.

Legal Business Name*

How Would You Like to Provide Your Information?*

I'll fill everything out online now I'll download the PDF version below, fill it out, and upload it

Click here to download the PDF version.

Accounts Payable Contact

All invoices are sent electronically to the invoice email address below.

A/P Contact Name*

A/P Phone*

Invoice Email Address*

Business Information

Enter N/A for anything that doesn’t apply.

Skip this section, I'll upload documents that cover it at the end.

DBA (If Applicable)

Business Type*

Federal EIN / Tax ID*

Years in Business*

Business Phone*

Business Email

Website

Physical / Service Address*

City*

State*

ZIP*

Billing Address (If Different)

Purchase Orders

We require a PO number on every invoice

Trade References

Three trade references are required. Suppliers or vendors you buy from on credit work best.

Skip this section, I'll upload documents that cover it at the end.

Trade Reference #1

Company Name*

Contact Name*

Phone*

Your Account # With Them

Trade Reference #2

Company Name*

Contact Name*

Phone*

Your Account # With Them

Trade Reference #3

Company Name*

Contact Name*

Phone*

Your Account # With Them

Bank Reference

Preferred, but not required.

Skip this section, I'll upload documents that cover it at the end.

Bank Name

Branch / Location

Bank Phone

Account Type

Account Number

Officer / Contact Name

Upload Documents

Upload your completed credit application, credit reference sheet, W-9, tax exemption certificate, or anything else that helps. PDFs or photos from your phone work fine, up to 10 MB each.

Upload Your Documents

Anything Else We Should Know?

Certification and Signature

Standard payment terms are Net 10 days from the invoice date. Bolted Box, LLC may charge interest of 1.5% per month (18% per year) on past due balances at its discretion.

The undersigned is duly authorized to execute this application and certifies that all information provided is true, accurate, and complete. By signing, I authorize Bolted Box, LLC to verify the references listed above and I agree to the payment terms stated on this form.

Agreement

I am authorized to sign for this business, and I agree to the terms above.

Signature (Type Your Full Name)*

Title*

Your Email*

Your Phone*

Date*

By typing your name, you are signing this application electronically.

Credit Request Form

Before You Start

Have These Handy

Payment Terms

Two Ways to Apply

Credit Request Form

Need a container on site?

Containers

Company

Customers

Contact