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

  • Please enter a number from 0 to 100.
  • Has any company officer or has the company ever filed for bankruptcy?

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  • Financial Information


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  • Vendor References

  • Business NameAddressPhoneFaxAccount Number
  • Business NameAddressPhoneFaxAccount Number
  • Business NameAddressPhoneFaxAccount Number

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  • 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.
  • Clear Signature
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