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  1. Fill in the form with the required information to open an account with us.
  2. You may use the following options to send us this application:
  • Use the submit button at the bottom of this page to E-Mail it to us.
  • Fill in the complete form, print it out, and Mail it to us.
  • Fill in the complete form, print it out, and Send it  by Fax.
  • Call our customer care center to register by phone.

Customer Account Application

senders e-mail
applicant
phone
fax
address
city
state
mailing address
city
state
Corporation Partnership Proprietorship
If proprietorship Social Security Number
how long in business
 years months
name of manager
federal id #
state id #
are P.O. # required for service? yes no
Are there specific people who can authorize service?
Authorized personnel
1
2
3
The undersigned Applicant & LKJ Towing agree that all credit extended to applican are subject to the following terms:

1.All amounts on each sale shall be due and payable in full within 30 days from Invoice Date.
2.If payment is not made by the due date there will be a late fee of 2% per month or 18% max per year until paid in full.
3.Payment sent in after due date with interest on the Invoice will be made in the following way. All interest will be paid first, then the account balance will be paid later.
4.If applicants account is referred for collection or attorney's the applicant understands they will be charged the additional fee's on top of invoice amounts owed.
5.This agreement may not be amended, altered or verified in any way except when written authorization is given by LKJ Towing.
6.I will personally guarantee payment of outstanding funds by submitting this application. All authrorized personnel can and will be held personally liable for outstanding debts of company.