CREDIT APPLICATION AND AGREEMENT CROWLEY' FULL LEGAL NAME LST LLC OWNERSHIP: CORPORATION PARTNERSHIP FEDERAL TAXPAYER I.D. NUMBER (OR SOCIAL SECURITY NUMBER) IF OCEAN TRANSPORTATION INTERMEDIARY ("OW), FMC LICENSE 4: IF 011, SPECIFY: CITI/freight forwarder OTI/NVOCC If OTI/NVOCC, show where tariff is located: 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) //AAL Aunric. 71 ept os • u.sv polio? BILLING ADDRESS (IF DIFFERENT) DATE A.1/9 L SOLE PROPRIETORSHIP OTI/freight forwarder & NVOCC -3 OTHER BUSINESS NAMES OPERATED UNDER____Oi4 PHONE 340 -115-QSar ,YEARS ESTABLISHED / 0 NO OF EMPLOYEES g STATE / COUNTRY OF INCORP otitioore NAMES OF SUBSIDIARIES / AFFILIATES BANK INFORMATION PRIMARY BANK NAME, A sir NI o_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 Crown. achi ADDRESS Crown (3a1 SLThonNoa COMPANY NAME Americo" Ync.k1 I4gvbor Chin R-117 ADDRESS (ol06 Rcd Rook nuarl-oCOMPANY NAME ken', 11O1-Crleik ADDRESS 11nOmOs. AUDITED FINANCIAL STATEMENT ATTACHED YES PHONE_ 3110 -774. S7OO CREDIT LIMIT PHONE_ 3'40 - -44Si / CREDIT LIMIT PHONE -S4O -1, 5-O66c CREDIT LIMIT SIGN BACK AND RETURN BY: MAIL • P.O. Box 2110, Jacksonville, FL 32203-2110 FAX - - EMAIL - EFTA00594124
