Credit Application – Jack Rich Lubricants



Main Office:

Jack Rich Lubricants, Inc.

617 Altamont Blvd.
Frackville, PA 17931

570-622-3000

Warehouse:

230 Jackson St.
Port Carbon, PA 17965

Jack Rich Lubricants Keep You Moving

Office Hours:

Monday – Friday: 8:00 am – 4:00 pm
Saturday & Sunday: Closed

* Please Complete The Credit Application Form Below
Completion and submission of the information is not an acceptance of extending credit nor binding on Jack Rich to provide credit. A Jack Rich representative will contact you with respect to your application.
Contact Jack Rich Lubricants with questions.

Commercial Credit Application

President(Required)
Delivery Address(Required)
Same as Delivery Address
Mailing Address(Required)
Email Address For Accounts Payable(Required)
Please enter a number from 0 to 100.
Bankruptcy(Required)
Has any company officer or has the company ever filed for bankruptcy?

 

Financial Information

Bank Address(Required)

 

Vendor References

Vendor Reference #1(Required)
Business Name
Address
Phone
Fax
Account Number
Vendor Reference #2(Required)
Business Name
Address
Phone
Fax
Account Number
Vendor Reference #3(Required)
Business Name
Address
Phone
Fax
Account Number

 

Payment can be made by credit card, however, there will be a 2% processing fee assessed.

Finance charges are accrued on accounts not paid within terms of account. The finance charge is computed by a periodic rate of 1 1/2% per month (18% per year) on unpaid balance. Any and all collection agency fees, court costs, attorney and miscellaneous fees will be claimed should your account be placed for collection for any reason.
Your Name(Required)
Email(Required)
eNewsletter, Promos & Notifications
This field is for validation purposes and should be left unchanged.