Business Contact Info Company Name Email Phone Number Fax Number Company Type Company Type List Sole Proprietorship Partnership Corporation Other Company Shipping Address City State / Province Posta / Zip Code Business and Credit Info Accounts Payable Contact Information First Name Last Name Email Phone Number Fax Number Company to Bill Address City State / Province Posta / Zip Code Bank Information * Bank Name Bank Address City State / Province Posta / Zip Code Phone Number Business References Reference 1 Company Name Address City State / Province Posta / Zip Code Email Phone Number Fax Number Type of Account Reference 2 Company Name Address City State / Province Posta / Zip Code Email Phone Number Fax Number Type of Account Reference 3 Company Name Address City State / Province Posta / Zip Code Email Phone Number Fax Number Type of Account Agreement (By checking these boxes you are agreeing to our terms - should you have any questions please contact us) Agreement and Terms All invoices are to be paid 30 days from the date of the invoice. All invoices are to be paid 30 days from the date of the invoice. Claims arising from invoices must be made within 7 business days of the invoice date. Claims arising from invoices must be made within 7 business days of the invoice date. By submitting this credit application, you authorize us to make inquires into the banking and buisness references that you provided. By submitting this credit application, you authorize us to make inquires into the banking and buisness references that you provided. Send
