Credit Application – Mobile Maintenance Association

Please fill out the Confidential Commercial Credit Application below to apply for credit with Mobile Parts & Equipment, LLC.

Contact Information

Raymond Gross
Direct: (310) 890-0371
Email: Sales@Zerk.Work

Step 1 of 2

Legal Business Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

DUNS Number

Federal Tax ID Number

Are You A Current Member Of The Mobile Maintenance Association? *

Years In Business *

Annual Revenue *

Primary Contact Name *

First

Last

Title *

Phone *

Email *

Requested Credit Amount

Do You Require PO Numbers? *

Parts Ship To Address *

Address Line 1

Address Line 2

City

State

Zip Code

Bank Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Bank Contact

Phone *

Trade Reference

Company Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Trade Reference

Company Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

I have completed this application to obtain credit, and herby certify that all statements thereof are true and correct. I authorize the release of such information to you. I understand and agree that any credit granted shall be paid in accordance with credit grantor’s terms of net 30 days from date of invoice. It is understood that the credit grantor may add 1.5% interest per month to any balance not paid in accordance within terms, and in the event of default, has the right to recover reasonable collection charges, attorneys fees, and court costs where applicable.

Name *

First

Last

Phone