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APPLICATION FOR CREDIT

( * ) a required field

Legal Name of Company :
Trade Name ( if different ) :
Mailing Address :
Civic Address :
Shipping Address :
Telephone No :
Fax No :
E-Mail Address : *
Confirm E-Mail Address : *


P.S.T Expempt : YesNo
If you answer Yes, please return a P.S.T. Exemption Certificate with this Credit Application.

Product or Service Supplied :
Sole Proprietorship :
Partnership :
Incorporated Co :
Date Business Started :
Annual Sales :
Number of Employees :

Owner #1 (Principles of Business)
Name :
Home Address :
Position/Title :

Owner #2 (Principles of Business) if applicable :
Name :
Home Address :
Position/Title :

Owner #3 (Principles of Business) if applicable :
Name :
Home Address :
Position/Title :


Contact Names:
Purchasing :
Accounting :

Business : Owned    Rented

Bank Information
Bank :
Phone No. :
Fax No. :
Bank Address :
Bank Manager:
Account # :

Credit References

Reference # 1
Name :
Address :
Phone # :
Fax # :

Reference # 2
Name :
Address :
Phone # :
Fax # :
Reference # 3
Name :
Address :
Phone # :
Fax # :

( IN ORDER TO EXPEDITE CREDIT APPROVAL PLEASE INCLUDE FAX NUMBER OF ALL REFERENCES )

Expected Amount of Monthly Purchases :
Amount of Credit Required :


To the best of my knowledge the above information is true. I/We understand that Advanced Prefabs Limited's terms of sale are NET 15th of the MONTH FOLLOWING and I/We agree to pay our account to these terms.

I/We agree that if payment is not made within the above terms then Advanced Prefabs Limited will enforce a 2% per month service charge on overdue accounts.

I/We agree and confirm that all merchandise shipped or consigned to me/us remains the property of Advanced Prefabs Limited until it is paid for in full.

By submiting this form for processing I/We permit Trades and Banks to reply to reference request submitted by Equifax/Advanced Prefabs Ltd.


  


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Designed and Maintained by: John Smillie / Lasting Impressions