FROM:       ______________________
TO:         U.S. Tow Service, Inc.
FAX NUMBER: 213-749-0272
ATTN:       U.S. Tow Service, Inc.
SUBJECT:    CREDIT APPLICATION

APPLICATION FOR CREDIT


__________________________________________
NAME OF FIRM OR INDIVIDUAL

__________________________________________  ____________________
ADDRESS                                     YEARS AT THIS ADDRESS

__________________________________________  ____________________
CITY                STATE    ZIP            AREA CODE    PHONE

HEREBY applies for credit in accordance with the terms and conditions of:

U.S. Tow Service, Inc.
1940 Lovelace Avenue Los Angeles, CA 90015

OUR NORMAL CREDIT TERMS: 30 Days net

The following information must be provided. It will be held in the strictest confidence.
OWNERSHIP: 
CORPORATION     PARTNERSHIP     INDIVIDUAL  
CHECK HERE IF INCORPORATED WITHIN THE PAST 12 MONTHS

______________________________  ______________________________
SOCIAL SECURITY #               FEDERAL TAX ID #

1.____________________  _____________________  _____  ________
  NAMES OF PRINCIPAL(S) COMPLETE ADDRESS       ZIP    PHONE

2.____________________  _____________________  _____  ________


3.____________________  _____________________  _____  ________


4.____________________  _____________________  _____  ________



FINANCE:     
__________________________  ________________________________
BANK                        BANK ADRESS

__________________________  ________________________________
BANK OFFICER OR DEPARTMENT  PHONE

REFERENCES:
1.____________________  _____________________  _____  ________
  BUSINESS NAME         COMPLETE ADDRESS       ZIP    PHONE

2.____________________  _____________________  _____  ________


3.____________________  _____________________  _____  ________


4.____________________  _____________________  _____  ________

CHECK HERE IF CASH SALES ARE OKAY UNTIL CREDIT IS APPROVED

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.


                                             (SIGNED)________________________

DATE_______________  YEAR_____               (TITLE)_________________________


PLEASE DO NOT WRITE IN THE SPACE BELOW

VERIFICATION:
_________________________   ______________________________
REFERENCE CHECKED BY           CREDIT APPROVED BY

_________________________   ______________________________
REFERENCE RESULTS              CREDIT REFUSED BY

_________________________     _______________________________
                              DATE

_________________________

Just print out this simple form on your office printer and fax it to 213-749-0272. Or call us at our 213-749-7100 telephone number and we'll fax an application to you promptly.