New Customer Form - JD Logisitics

JD Logistics New Customer Form

For your security, all data submitted through this form is automatically purged from our online database within 7 days of your submission. If you have any questions or concerns regarding the security of your information, please send an email regarding your concerns to josh@jdlogistics-inc.com.

JD New Customer Form

Company Information

Please select the JD representative with whom you are working:

Company Name

Company Phone

Fax

Registered Company Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Billing Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Business Information

Date Business Commenced

Tax ID Number

Type of Business Entity

DUNS Number

Other

Are you a part of any network?

WCA

WFN

WWPC

Other

Accounting Information

Accounts Payables Contact Name

Security Information

Is your company involved in C-TPAT or any other security programs?

If you are a participating member of C-TPAT please provide your SVI #

If you are participating in any other security programs please list them:

Agreement

I/We agree to pay all collection costs, court costs, and legal fees incurred to collect delinquent balances.

I/We certify that the foregoing information is complete, accurate, and voluntary for the purposes of obtaining credit in connection with our business.

Signature

Title