Customer Credit Application

CARRIERS WORLD WIDE INC.

6127 Lake Worth Road 

Lake Worth, FL 33463

(561) 649-5844 Phone

(561) 649-0184 Fax

(800) 900-9644 Watts                                                       

Company Name:                                                            

Street Address:                                                                             

City/State/Zip:                                                                               

Owner/President:                                                                          

Comptroller:                                                                                  

Accounts Payable Supervisor:                                                      

Paperwork Required For Payment:                                                                                                      

Bank:                                                 Rep:                                                Account #                             

Trade References

(1)                                                                                                                                                               

(2)                                                                                                                                                               

(3)                                                                                                                                                               

This application for credit, is made by the named company & Carriers World Wide, Inc. The named company agrees to pay

 all Invoices and  charges within 30 day s from the  original shipping date.  The named company   agrees  to a service  charge

 of  1&1/2% per month (18% annual rate) on any overdue balances.  The named company agrees to pay all collection fees &

 costs including all attorney fees and waives all rights to claim exemptions under state law.

Signed                                                       Title                                           Date