CUSTOMER APPLICATION

Company Name*

Tax Classification*

Tax ID # / EIN*

Contact Name*

Email*

Phone*

Business Address*

Business Hours*

Add Hours

Payment Terms

Payment Type

ACH Bank Transfer

Credit Card (3% Fee)

Remittance Address
Trux Freight Inc
PO Box 660574
Arcadia, CA 91066

Remittance Contact
Accounts Receivable
Email: ac@truxfreight.com
Phone: (951) 878-9436

ACH Remittance Info
Bank Name: Wells Fargo
Routing #: 121042882
Account #: 121000248

ACH Payment Authorization

Name on Account

Bank Name

Routing Number

Account Number

ACH Authorization

We authorize Trux Freight Inc to initiate payment via ACH bank transfer.

We will initiate payments to Trux Freight Inc via ACH bank transfer.

I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the noted submission date below. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I will not dispute Trux Freight Inc's billing with my bank so long as the transaction corresponds to the terms indicated in this agreement.

By submitting this form, you agree that you are an authorized person to do so on behalf of said company named above. You also agree that all payments must be submitted or transferred within 7 days upon receipt of invoice, unless otherwise agreed upon. In the case of payments being rejected for Non-Sufficient Funds (NSF), you understand that Trux Freight Inc may at its discretion send an invoice within 7 days of rejected funds, and you agree to an additional charge of $30 for each attempt for returned NSF, which will be invoiced as a separate transaction from the original payment. You will receive an email with a copy of the information submitted in this form. Please contact Trux Freight Inc by email or phone if any information is incorrect.

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