Cash On Delivery Account Application (Updated 2025)

"*" indicates required fields

Step 1 of 3

Customer Delivery Information

Receiving Hours – Opening

Receiving Hours – Closing

Delivery Options

Commercial

Residential

Forklift Unload

Hand Unload

Truck Size

Pickup

Bobtail

Semi-truck

Digital Invoice Email

To receive alerts on your delivery status through text and/or email, please fill out the information below

Delivery Alerts Cell Phone

Delivery Alerts Email

Customer Information

Company*

Phone*

Fax

Billing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Delivery Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Owner's Name

Driver's License

Social Security

Email*

Home/Cell Phone

Owner's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Commercial Business References

Company #1 Name

Company #1 Phone

Company #1 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company #2 Name

Company #2 Phone

Company #2 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Bank Reference

Bank Name

Bank Account #

Bank Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

IN THE EVENT IT BECOMES NECESSARY FOR PETERMAN LUMBER INC. TO FILE SUIT TO ENSURE PAYMENT OF ANY DISHONORED CHECKS OR UNPAID PURCHASES, PETERMAN LUMBER INC. SHALL BE ENTITLED TO ANY COLLECTION FEES; ACTUAL ATTORNEY FEES; AND ALL COST INCURRED. I FURTHER AGREE THAT THE LAWS OF THE STATE SHALL APPLY AND THAT IN THE EVENT THERE IS LITIGATION COMMENCED TO ENFORCE THIS GUARANTEE, THE VENUE FOR SUCH ACTION SHALL BE IN SAN BERNARDINO COUNTY, CALIFORNIA, OR AT THE DISCRETION OF PETERMAN LUMBER INC.

ABOVE INFORMATION IS TRUE AND CORRECT. PETERMAN LUMBER INC. MAY VERIFY THE ABOVE INFORMATION; CHECK THE UNDERSIGNED’S CREDIT HISTORY; AND REPORT AUTHORIZED PERSONS AND CREDITED BUREAUS CONCERNING THE UNDERSIGNED’S CREDIT PERFORMANCE UNDER THIS AGREEMENT

Signature*

Print Name

First Last

Title

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