Credit Application
CREDIT APPLICATION FORM
Date:
Corporate Name:
Trade Name:
Billing Address:
Street:
City:
Province:
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Postal Code:
Business Telephone:
Home Telephone:
Fax:
Email Address:
Corporation:
Proprietorship:
Partnership:
Date Business Established:
LIST OF OFFICERS (CORPORATION ONLY)
President:
Treasurer:
Manager/Accounts Payable:
Sales Tax Licences:
Provincial:
G.S.T.:
Credit Line Requested:
Are P.O.'s Required:
Yes:
No:
Contact Name:
CREDIT REFERENCES:
1. Complete Name:
1. Complete Address:
1. Phone:
1. Fax:
2. Complete Name:
2. Complete Address:
2. Phone:
2. Fax:
3. Complete Name:
3. Complete Address:
3. Phone:
3. Fax:
BANK REFERENCE:
Bank:
Phone:
Contact:
TERMS: PAYMENT TERMS ARE NET 30 DAYS
Date:
Name:
Position:
DECLARATION:
The information given is warranted to be true and given for the purpose of obtaining credit and in the event credit is given, I/We agree to abide by your terms of sale. I/We agree to pay service charges on overdue accounts at the rate shown on your invoice terms.
