W.J. Donovan Mayflower W.J. Donovan Mayflower
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Contact UsCredit Application 1-800-252-8765


Contact Donovan/Mayflower

Please take a few moments to fill out the form below. Remember to fill in all fields that are marked with an asterisk (*) in order to process your information. You may also contact us directly @ 800-252-8765.

Please enter your Personal Information below
* indicates required field
  W.J. Donovan Sales Contact*
  First Name*
  Last Name*
  Company
  Email*
  Address 1*
  Address 2
  City*
  State*, Zip*  , 
  Country
  Phone*
  Fax
  Federal Tax ID/SSN*
  D & B Number
  Type of Business


Please enter Principal Information below
* indicates required field

  FIRST PRINCIPAL:
  First Name*
  Last Name*
  Title*
  Address 1
  Address 2
  City
  State, Zip  , 
  Phone*
  Fax

  SECOND PRINCIPAL:
  First Name*
  Last Name*
  Title*
  Address 1
  Address 2
  City
  State, Zip  , 
  Phone*
  Fax


Please enter Banking and Billing information below
* indicates required field

  BANKING INFORMATION:
  Bank Name*
  Contact*
  Account Number*
  Phone*
  Fax*

  BILLING INFORMATION: (Send Invoice To)
  Pay Cycle*
  Monthly Credit Requirement*
  (estimated in $)
  Full Name*
  Address 1
  Address 2
  City
  State, Zip  , 

  BILLING INFORMATION: (Accounts Payable Contact)
  Full Name*
  Phone*
  Fax*
  Email


Please enter EDI information below
* indicates required field

  EDI INFORMATION:
  Are you EDI Capable?   Yes   No
  EDI Contact - Full Name
  EDI Contact - Phone
  EDI Contact - Fax
  Transaction Set
  (check all that apply)		   210 (Frt Details Invoice)
  820 (Remittane Advise)
  997 (Transmission Acknowledgement)


Please provide two Carrier References below
* indicates required field

  REFERENCE 1:
  Business Name*
  Address 1*
  Address 2
  City*
  State, Zip*  , 
  Phone*
  Fax*

  REFERENCE 2:
  Business Name*
  Address 1*
  Address 2*
  City*
  State, Zip*  , 
  Phone*
  Fax*


Please review the Agreement and submit your information

THE AGREEMENT:
The above information is for the purpose of obtaining credit and is warranted to be true. I/We hereby authorize W.J. Donovan - Mayflower to investigate references pertaining to my/our credit and financial responsibility. I/We further hold W.J. Donovan - Mayflower harmless against any claims, direct or indirect that may result from receiving such information. The documented results transmitted via this online form is shall be the original.

On behalf of our company, I certify we are familiar with and agree to abide by Federal rules and regulations pertaining to the payment of transportation and other tariff charges. I/We agree to pay within W.J. Donovan - Mayflower terms of NET 15. It is further understood that under the law, a carrier is required to discontinue further credit when a patron violates the time allowed for payment of tariff charges. Applicant shall assume any costs incurred by W.J. Donovan - Mayflower for delinquent accounts.

Unless a greater value is declared and an excess value fee paid, it is agreed and declared that all property shipped has a released value of fifty ($0.50) cents per pound. Declared value not available on personal effects, jewelry, antiques, works of art or intangibles.
Name of Authorized Representative*
Title of Authorized Representative*
I've read and Agree to the terms above* YES
  

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