Xpedite Logistics
CUSTOMER INFORMATION
          Fax 210-798-1035

Company Name:_________________________________________________Telephone:__________________

Address:______________________________________________________Fax Number:__________________

             ______________________________________________________Tax I.D. No:___________________

Billing Address: _______________________________________________________________

Send invoices to the attention of:________________________Telephone:____________________

Type of business:

Corporation Partnership  Association   Individual

References:

Business Name:____________________________________________________________________________

Telephone:__________________________ Account No:_________________________

Business Name:____________________________________________________________________________

Telephone:__________________________ Account No:_________________________

Business Name:____________________________________________________________________________

Telephone:__________________________ Account No:_________________________

Billing Reference: Each time you place an order we can ask you to provide us with a specific reference
number or name, such as "job number", "Client/Matter", etc. which will appear on your invoice.
Please choose one of the following:

No reference needed    Client Number Client/matter Job Number  Cost Center
Department  Other ___________________________________________

In consideration of Xpeditelogistics extending credit to Applicant, Applicant agrees to pay
for services due upon receipt of the invoice for said services.

Signature of individual authorized to open a credit account in the name of your company:

IMPORTANT:
Authorized Signature:______________________________ Date:____________