New Customer Worksheet for Non-Credit Customers

Use this form if you do not wish to apply for a credit account with Protective Equipment Testing Laboratory.

Customers of this group will be required to pay for services at the time they are rendered.  If you would like NET30 terms or similar, please complete the New Customer Worksheet for Credit Customers instead.

PLEASE NOTE:  We will call you for credit card billing information before we ship your items back to you.


Contact Information:
Responsible Party
Frequency of Testing

*Please note testing fees are different for replacement customers and non-replacement customers.

Truck Inspection
Name of Person Responsible for Truck Inspections (If Applicable)

Terms and Conditions

This is a NON-CREDIT worksheet.  Any fees charged to this account are due immediately.  PETL will contact you for credit card billing information before shipping your items back.  Any amount that is past due will be charged a 1.5% per month finance charge, with a minimum of $5.00 per month until all debt is paid in full.  Any collection costs, attorney fees, and court expenses will be your responsibility and added to the unpaid balance.

By submitting this form, you agree that your typed signature below will have the same full legal force and effect as your handwritten signature.  Signing this agreement indicates your acceptance of the terms and conditions as stated.

This form will not be processed without a signature.