Please complete the form below. If you prefer to download a PDF and submit via email, click here and email the completed form to





TRADE REFERENCES (List three references that are not EFT or COD)

CREDIT TERMS: Our open account terms are Net 30 Days from product delivery date. Any and all accounts over 30 days in aging may accrue a services charge at the rate of 3.5% per month (18% annual) on open balances. I/We authorize OTL-UPT to investigate the references listed above pertaining to my/our credit and financial responsibilities. The undersigned hereby agrees that should a credit account be opened, and in the event of default in the payment of any amount due, and if such account is submitted to a collection authority, to pay any additional charges equal to the cost of collection including court costs and attorney fees.

By entering your name in the signature field, you agree that the signature will be the electronic representation of your signature for all purposes when the signee (or his/her agent) use them on documents, including legally binding contracts - just the same as a pen-and-paper signature.

The above information is for the purpose of obtaining credit and is warranted to be true and correct. I/we hereby authorize United Petroleum Transports (UPT) to investigate my/our credit and financial responsibility. I/we hereby authorize my/our banks, trade references, and credit bureau agencies (ID needed) to release to UPT. any information required to process the request for credit extension. Applicant’s signature attests financial responsibility, ability, and willingness to pay UPT. invoices in accordance with the terms and conditions stated in this application. In the event of non-payment, customer agrees to pay reasonable collection fees, attorney fees and court costs incurred to collect unpaid debt in addition to the balance due. Signatory also confirms Review of payments instructions for Wire/ACH transactions and email remittance, as well as access to UPT’s Transportation Motor Carrier/Shipper Agreement.