Individual or Company Legal Name_______________________________________________________________

Street Address_______________________________________________________________________________

                       _______________________________________________________________________________

City____________________________________________________ State________________ Zip____________

Phone__________________________________________ Fax________________________________________


Corporation          Limited Partnership          Partnership          Individual


Names of Owners, Officers, or Partners:

_______________________________________________________ Title________________________________

_______________________________________________________ Title________________________________

_______________________________________________________ Title________________________________


Federal Tax ID#/ PAN#_________________________________ Dun & Bradstreet#_________________________


Expected monthly credit required from Interport Global Logistics Pvt. Ltd.$________________________________

Contact person for Accounts Payable_______________________________________________________________

Phone__________________________________________ Fax__________________________________________


Specific Instructions/Requirements for Interport Global Logistics Pvt. Ltd. invoicing procedures:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________


BANK (CHECKING ACCOUNT)



Name of Bank____________________________________ Name of Bank Official_____________________________

Address_______________________________________________________________________________________

             _______________________________________________________________________________________

Account Number_________________________________________________________________________________

Phone__________________________________________ Fax____________________________________________


Page 1 of 2 BUSINESS REFERENCES



Name______________________________________________________ Phone_____________________________

Fax____________________________ Contact Name___________________________________________________

Address_______________________________________________________________________________________

             _______________________________________________________________________________________



Name______________________________________________________ Phone_____________________________

Fax____________________________ Contact Name___________________________________________________

Address_______________________________________________________________________________________

             _______________________________________________________________________________________



Name______________________________________________________ Phone_____________________________

Fax____________________________ Contact Name___________________________________________________

Address_______________________________________________________________________________________

             _______________________________________________________________________________________


Application is hereby made and references given.  It is understood that this particular information will be held in complete
confidentiality and used only by the credit department of Interport Global Logistics Pvt. Ltd.  If approved, I hereby agree to
the credit terms of Net/30.


Signed___________________________________________________ Title______________________________

Date_________________________


Please fax completed application to 91+22+56415643 . Also please mail original to:

Interport Global Logistics Pvt. Ltd.
Attn:  Credit Dept.
Shrikant Chambers, 5 & 6, Ground Floor,
Sion Trombay Road, Next to R. K. Studio,
Chembur, Mumbai - 400 071
Tel.: 91+22+56415641 (30 Lines)