Carrier Application

Full Name:
Current Address:
How Long?
Previous Address:
How Long?
Phone Number
Email Address

The delivery of newspapers is required 365 days per year. The Independent Carrier is not personally obligated to deliver the newspapers each and every day. However, if for any reason the Independent Carrier is not going to personally deliver the newspapers, it is his/her obligation to obtain a substitute for the route.

I understand this arrangement Yes  No

EMPLOYMENT:

 

Place of Employment

Position

Supervisor

Dates From/To

1.

2.

3.

The following information will be needed to determine preliminary Bond eligibility:

CREDIT REFERENCES:

Name of Firm

Address

Length of Account

ROUTE INFORMATION
What area would you be interested in delivering newspapers in?
TRANSPORTATION INFORMATION
Do you own an automobile? Yes No
Insurance Company:
Driver's License Number: State:

The delivery of newspapers will, generally, require a vehicle. It is the Independent Carrier's obligation to provide that vehicle. Any breakdowns or mechanical failures of the vehicle will not excuse the Independent Carrier from the obligation to deliver the routes. All contingency plans will be made by the Independent Carrier.

I understand this arrangement Yes  No

*All statements appearing on this form are true and correct and are made for the purpose of obtaining credit as an Independent Contractor from The Springfield News-Leader. This form and all information secured pursuant to its authority shall be and remain the property of The Springfield News-Leader whether or not credit is granted hereunder.

*The Springfield News-Leader, and any of its employees, officers or agents are authorized to obtain a personal credit bureau report concerning Applicant’s credit worthiness.

*The Springfield News-leader is authorized to disclose to the proper persons and Bureaus Applicant’s credit performance.

*In the event of default hereunder, the Applicant agrees to pay court cost, reasonable attorney fees and collection fees.

*If credit is granted by The Springfield News-Leader to or for the benefit of the Applicant, the Applicant will pay when due all obligations of the undersigned to The Springfield News-Leader.

*Credit granted to the Applicant may, at the option of The News-Leader, be cancelled at any time upon notice to the Applicant.

*Applicant’s submission of this form hereon constitutes consent agreement and absolute right to obtain a credit bureau report on applicant.

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