Credit Application Form

"*" indicates required fields

Axis Team Member Contact

Axis Team Email*

Credit Application

Name*

Company*

DBA

Street Address*

City*

Choose a State*

Zip*

Country*

Business Phone*

Cell Phone

Email*

AP Email (If Different)

Years In Business*

Federal Tax ID*

Tax Classification*

Tax Exempt Sale?*

Tax Exempt Rental?*

Tax-Exemption Number

Purchase Order # Required?*

Does your company require invoices to be submitted through an invoice submission portal?*

Principals of Company:

Full Name*

Address*

Title*

Full Name

Address

Title

Requested Credit Limit: *Terms to be NET 30 DAYS

Requested Dollar Amount For Credit

Banking Information

Bank Name*

Phone*

Fax

Address*

Bank Officer

Personal Guaranty

For valuable consideration, including the extension of credit to Applicant, the undersigned individual (“Guarantor”) hereby guarantees the full and prompt payment of all amounts due or to become due from Applicant to Seller, whether now existing or hereafter arising.

This guaranty is a continuing guaranty of payment. Seller may proceed directly against Guarantor without first pursuing Applicant or any collateral. This guaranty shall remain in effect until revoked in writing by Guarantor; however, such revocation shall apply only to credit extended after Seller’s written acknowledgment of revocation, and all obligations incurred prior thereto shall remain fully enforceable.

Guarantor waives notice of acceptance of this guaranty and agrees that this guaranty shall be governed by the laws of the State of Arizona. Guarantor irrevocably submits to exclusive jurisdiction and venue in the state or federal courts located in Maricopa County, Arizona.

Name*

Address*

Signature*

Date*

Supporting Documentation

Tax Certificate

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.

(Must be submitted with application for each state doing business.)

Government-Issued Photo Identification

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.

(Please upload a clear copy of a valid government-issued photo ID (e.g., Driver’s License or Passport) for identity verification purposes.)

Agreement & Authorization

The undersigned represents and warrants that he or she is duly authorized to execute this Credit Application on behalf of Applicant and has full power and authority to bind Applicant to all terms and obligations contained herein. Applicant agrees this Credit Application constitutes a valid, enforceable, and binding obligation of Applicant.

View Axis Portable Air Rental Terms & Conditions

Credit Terms & Conditions*

I have read and agree to Axis Portable Air Credit Terms & Conditions *

Name*

Signature*

Date*

Phone

This field is for validation purposes and should be left unchanged.

Credit Application Form

Axis Team Member Contact

Credit Application

Principals of Company:

Requested Credit Limit: *Terms to be NET 30 DAYS

Banking Information

Personal Guaranty

Supporting Documentation

Agreement & Authorization

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