CHIEF RAPID RENTAL ACCOUNT APPLICATION

Primary Contact Person *

First Name

Last Name

Primary Contact Phone *

(###)

###

####

Business and Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Billing Address (if different)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Business Structure *

C-Corp

S-Corp

LLC

LP/LLP

Partnership

Proprietorship

Government

Other

Date Business Started *

MM

DD

YYYY

Accounts Payable Contact *

First Name

Last Name

Job Names and/or Job Numbers for Invoicing *

YES

NO

Purchase Order Numbers

YES

NO