Credit Application
 

Company Info
Company Name:  
Company Address:  
City:  
Postal Code:  
Credit Required:  
Type of Business:  
No. of Years:  
Email Address:  
Accounts Payable Clerk:  
Email Address:  
Contact/Controler  
Tel#:  
Fax#:  

Contact Info
Prinicpal Name: Position: Tel #:  
Prinicpal Name: Position: Tel #:  

Bank Information
Bank Name:  
Bank Address:  
Account #:  
Contact Name:  
Bank Tel#:  
Fax #:  

Company References
Co. Name: Tel:#  
Address: Yrs Dealing:  
         
Co. Name: Tel#:  
Address: Yrs Dealing:  
Co. Name: Tel:#  
Address: Yrs Dealing:  


Sender Full Name: * Required
Senders Email: * Required
 
   
   

Note: Payments must be received within 30 days in order to maintain Credit Privileges. All past due accounts will be placed on Credit hold until brought within terms.


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