LinkCredit

{CustName}
Customer Profile
Company Name

:

Doing Business As

:

Address

:

Postal Code

:

Officer

:

Office Phone #

:

Fax #

:

Toll Free #

:

Business Type

:

Bank

:

Bank Province

:

Report Date

:

MC#

:

Business Estab.

:

Remarks

:
Corporate Strength
Annual Sales

:

Avg Yrs Ac Open

:

Avg Cr. Extend

:

Avg Pay Trend

:

Collections Activity

:

Employees

:

Credit Score Risk

:
Score History

Authorities and Insurance
Information Provided By FMCSA

MC#:

Required

On File

Broker

Contact

Common

BIPD

Authority

Cargo

Pending

Bond

Revoked

BIPD Co

:

BIPD No

:

BIPD Date

:

Cargo Co

:

Cargo No

:

Cargo Date

:

Bond Co

:

Bond No

:

Bond Date

:
Send Freight Bill To
Bill Address

:

Postal Code

:

Required Docs

:

{CustName}
Customer Profile DET
Company Name

:

Address

:

Total Owed

:

File Opened

:

Refresh Date

:

Tel #

:

Fax #

:

Equifax Member #

:

Equifax Subject #

:

Payment Index

:

Composite Index

:
Negative Occurrences
Total Number

:

Total Amount

:

Date Of Last

:
TOTAL#

TOTAL$

LAST ONE

Collection Claims

Legal Suits

Judgements

Returned Cheques

Total Neg. Occ.

N/A

Other Legal
Payment Trend
P.I.

C.I.

Num

Dispute

HCurL

HCurL

Time

Lines

TotalOwing

%Cur

%Per1

%Per2

%Per3

Holdback

Cur. Qtrs

{CustName}
Customer Profile
Company Name

:

Address

:

Report Date

:

Organized As

:

Officer

:

Office Phone #

:

Fax #

:

Fed Tax ID#

:

800#

:

Bus Type#

:

Bank

:

Dot#

:

Business Estab.

:

Remarks

:

Zip

:

Bank State

:
Corporate Strength
Annual Sales

:

Avg Yrs Ac Open

:

Avg Cr. Extend

:

Avg Pay Trend

:

Collections Activity

:

Employees

:

Credit Score Risk

:
Score History
DOT Authorities and Insurance

Required

On File

Broker

Contact

Common

BIPD

Authority

Cargo

Pending

Bond

Revoked

Bond Co

Bond No

Bond Date

Fund Co

Fund No

Fund Date

Cargo Co

Cargo No

Cargo Date

Liability Co

Liability No

Liability Date

Send Freight Bill To
Address

:

Zip

:

Required Docs

:

{CustName}

Insurance 1
Company Name

:

Insurance Broker

:

Policy

:

Expiry Date

:

Comm. Gen. Liability

:

Cargo Ins. Coverage

:
Insurance 2
Company Name

:

Insurance Broker

:

Policy

:

Expiry Date

:

Cargo Ins. Coverage

:

{CustName}
Company Name

:

Legal Name

:

Prov/State

:

Ontario CVOR #

:

PQ NIR #

:

Agency Letter on File

:
Motor Carrier
MC/ICC #

:

U.S. DOT #

:

Authorities:

Common-Auth

Contract-Auth

Broker-Auth

Commodities Lic:

General Freight

House Hold Goods

Hazardous
Hazmat
Hazmat Reg #

:

Expiry Date

:
Broker Surety Bond Numbers
Cnd Broker

:

Cdn Amount

:

Cnd Exp Date

:

USA Broker

:

USA Amount

:

USA Exp Date

:

Continual

:

Freight Fwd

:
Bond Status
Bonded Carrier Canada

Bonded Carrier U.S.A

NOTE:All items in Red are not verified
Canadian Authorities
AB

BC

MB

NB

NF

NS

NT

ON

PE

PQ

SK

YK

{CustName}
Legal Name

:

Contact(s)

:

Location

:

{CustState}

Business Type

:

Phone

:

Alternate Phone

:

Fax

:

Hours

:

Web site address

:

Contact E-mail

:
Annual Sales

:

Avg Yrs Open

:

Avg Cr. Extend

:

Avg Pay Trend

:

Collections Activity

:

Business Estab.

:

Employees

:

MC#

:

Doing Business As

:

Credit Score Risk

:
File Opened

:

Total Neg. Occur

:

Total Neg. Amt.

:

Neg.Occ.Last Date

:

Refresh Date

:

Payment Index

:

Composite Index

:
Annual Sales

:

Avg Yrs Open

:

Avg Cr. Extend

:

Avg Pay Trend

:

Current Mgmt

:

Collections Activity

:

Business Estab.

:

Employees

:

Federal Tax ID#

:

Dot #

:

Credit Score Risk

:

{CustName}
Company Name

:

Subscriber Type

:

Contact(s)

:

Location

:

{City}, {CustState}

Business Type

:

Our Slogan

:

Phone

:

Alternate Phone

:

Fax

:

Hours

:

Website

:

Email

:

Dispatch Comments

:

Save

Cancel
Annual Sales

:

Avg Yrs Open

:

Avg Cr. Extend

:

Avg Pay Trend

:

Collections Activity

:

Business Estab.

:

Employees

:

MC#

:

Doing Business As

:

Credit Score Risk

:
File Opened

:

Total Neg. Occur

:

Total Neg. Amt.

:

Neg.Occ.Last Date

:

Refresh Date

:

Payment Index

:

Composite Index

:
Annual Sales

:

Avg Yrs Open

:

Avg Cr. Extend

:

Avg Pay Trend

:

Current Mgmt

:

Collections Activity

:

Business Estab.

:

Employees

:

Federal Tax ID#

:

Dot #

:

Credit Score Risk

:

Average Days Past Due:

Prompt

Slow to 15 days

Slow to 30 days

Slow to 60 days

Slow to 90 days

90+

Over 90 days

Average Days Past Due:

Prompt

Slow to 15 days

Slow to 30 days

Slow to 60 days

Slow to 90 days

90+

Over 90 days

Risk:

Low

0.0

- 20.0

Moderate

20.1

- 30.0

High

30.1

- 99.9

Risk:

Low

0.0

- 20.0

Moderate

20.1

- 30.0

High

30.1

- 99.9

Risk:

Lowest

85+

Moderate

70-84

High

55-69

Extreme

00-54

Risk:

Lowest

85+

Moderate

70-84

High

55-69

Extreme

00-54

Risk:

Lowest

85+

Moderate

70-84

High

55-69

Extreme

00-54

Risk:

Lowest

85+

Moderate

70-84

High

55-69

Extreme

00-54

Payment Index Key

Payment Index Key

Composite Index

Composite Index

Credit Score Risk

Credit Score Risk

Credit Score Risk

Credit Score Risk