Fleet & Shop Credit Application

Apply for trade pricing, priority sourcing and requested net terms. A JAK'S Diesel specialist will review the application and follow up directly.

Required field

Business information

Company legal name

DBA or trade name

Business type

Years in business

Company website

Primary contact

Contact name

Title or role

Phone

Preferred contact

Accounts-payable email

Billing and shipping

Billing address

Primary shipping address

Purchasing and credit request

Estimated monthly diesel-parts purchases

Requested terms

Purchase orders required?

Tax-exempt?

Engines, equipment and parts you purchase

Trade references

References help us evaluate net terms; they are not required for a trade-pricing account paid by card.

Additional details

I am authorized to submit this application for the company above, and the information is accurate.

Submitting an application does not guarantee approval or a particular credit limit. JAK'S Diesel may contact the business and references to verify the information supplied.

Questions? Call or text (720) 445-6249.