EFTA00594124.pdf

CREDIT APPLICATION AND AG REEMENT CROWLEY' FULL LEGAL NAME LST LLC DATE A.1/9 L OWNERSHIP: CORPORATION PARTNERSHIP SOLE PRO PRIETORSHIP FEDERAL TAXPAYER I.D. NUMBER (OR SOC IAL SECURITY NUMBER) IF OCEAN TRANSPORTATION INTE RMEDIARY ("OW), FMC LICENSE 4: IF 011, SPECIFY: CITI/freight forwarder OTI/NVOCC OTI/freight forwarder & NVOCC If OTI/NVOCC, show where tariff is locat ed: OTI/freight foiwarder: bond it: surety: Amount $ effective date: OTI/NVOCC: bond 4': surety: Amount $ , effective date: IF ENGAGED IN INTERNATIONAL SHIPPING LIST: STEAMSHIP LINES COUNTRIES SHIP TO / FROM MAILING ADDRESS (.(()0 etc) //A A L Aunric. -3 71 ept os • u.sv polio? BILLING ADDRESS (IF DIFFERENT) OTHER BUSINESS NAMES OPERATED UNDER____Oi 4 PHONE 340 -115-QSar ,YEA RS ESTABLISHED /0 NO OF EMPLOYEES STATE / COUNTRY OF INCORP otitioo g re NAMES OF SUBSIDIARIES / AFFILIATES BANK INFORMATION PRIMARY BANK NAME, A sir NIo_k CONTACT PHON ACCOUNTS) NO. ADDRESS S. . fl oe, a 05 Virsin 154 OTHER BANK NAME CONTACT PHONE ACCOUNT(S) NO TRADE REFERENCES COMPANY NAME. 111- $.11 . It Cro wn. achi PHONE_ 3110 - 774. S7OO ADDRESS Crown (3a1 SLThonNoa CREDIT LIMIT COMPANY NAME Americo" Ync.k1 I4gvbor Chin R-11 7 PHONE_ 3'40 - ADDRESS -44/Si (ol06 Rcd Rook nuarl-o- CREDIT LIMIT COMPANY NAME ken', 11O1 -Crleik ADDRESS PHONE -S4O -1, 5-O66c 11nOmOs. CREDIT LIMIT AUDITED FINANCIAL STATEMENT ATTACHE D YES SIGN BACK AND RETURN BY: MAIL • P.O. Box 2110, Jacksonville, FL 32203-2110 FAX - - EMAIL - EFTA00594124