Parts

Credit Application

* asterisk denotes required information


*Contact Name
*Name of firm or Individual
*Address
*City
*State/Province
*Zip / Postal Code
*Phone
*Fax
*Years at this Address

Terms

Normally, Net 30 EOM


Ownership

Corporation
Partnership
Individual

Incorporated within the past 12 months?

*Name of principals
*Complete Address *City *State *Zip *Phone
Name of principals
Complete Address City State Zip Phone

Finance

*Bank
*Address
*City
*State
*Zip
*Phone
*Department or Officer

References

(3 required)

*Business Name
*Complete Address *City *State *Zip *Phone
*Business Name
*Complete Address *City *State *Zip *Phone
*Business Name
*Complete Address *City *State *Zip *Phone
Business Name
Complete Address City State Zip Phone

Check here if credit card or COD is okay until terms are established.

We certify that all the information on this form is correct. We fully understand your credit terms and agree to the proper payment in consideration of extended credit.

*Date
*Submitted by
*(Title)

Contact Us

Parts Department: 800-247-2560
Fax: 515-256-5555

Local: 515-256-5300

Location

Des Moines Flying Service, Inc. Des Moines International Airport
P.O. Box 35126 (50315-0302)
5600 Fleur Drive
Des Moines, IA 50321

Shipping Address

Des Moines Flying Service, Inc.
Des Moines International Airport
5600 Fleur Drive
Des Moines, IA 50321