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Application For Open Account Credit For Stocking Dealers - Legal Forms
| Application For Open Account Credit For Stocking Dealers Form. This is a Legal Forms form and can be used in Credit And Collection . |
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APPLICATION FOR OPEN ACCOUNT CREDIT FOR STOCKING DEALERS COMPANY NAME: _____________________________________________________ D/B/A: _____________________________________________________ BILLING ADDRESS: _____________________________________________________ _____________________________________________________ SHIPPING ADDRESS: _____________________________________________________ _____________________________________________________ PHONE NUMBER: ___________________________ FAX NUMBER: ______________________________ OWNER NAME: ___________________________ SALES TAX NUMBER: _______________________ BUYER: ____________________________________ STORE SIZE: ____________________________ SQ. FT. BOOKKEEPER: ______________________________ NUMBER OF EMPLOYEES: ________________ NUMBER OF YEARS IN BUSINESS UNDER CURRENT OWNER: ___________ PURCHASE SUBJECT TO SALES TAX? [ ] YES [ ] NO PURCHASE ORDERS REQUIRED? [ ] YES [ ] NO LINE OF CREDIT REQUESTED: $____________________ TYPE OF COMPANY: [ ] SOLE PROPRIETORSHIP [ ] PRIVATE CORP. [ ] PARTNERSHIP [ ] PUBLIC CORP. [ ] OTHER ___________________________ 2001 © American LegalNet, Inc. TYPE OF BUSINESS: ___________________________ BANK BRANCH: __________________________________ BANK CONTACT: _________________________________ BANK ADDRESS: _________________________________ PHONE NUMBER: _________________________________ FAX NUMBER: ____________________________________ ACCOUNT NUMBER: ______________________________ TRADE REFERENCES (Please give complete addresses and account numbers): 1. COMPANY: ________________________________________ ADDRESS: _________________________________________ PHONE: _________________ FAX: __________________ ACCOUNT NUMBER: ________________________________ 2. COMPANY: ________________________________________ ADDRESS: _________________________________________ PHONE: _________________ FAX: __________________ ACCOUNT NUMBER: ________________________________ 3. COMPANY: ________________________________________ ADDRESS: _________________________________________ PHONE: _________________ FAX: __________________ ACCOUNT NUMBER: ________________________________ 4. COMPANY: ________________________________________ ADDRESS: _________________________________________ PHONE: _________________ FAX: __________________ ACCOUNT NUMBER: ________________________________ 2001 © American LegalNet, Inc. To the best of my knowledge the above facts are represented as true. I am aware that falsification of any of this information may result in denial of credit by ___________________________________ Inc. My signature below indicates my permission for ___________________________________ Inc., to obtain credit information from the sources I have referenced, including any external credit reporting source, and any consumer credit agency. I understand that interest will be charged on all past due balances at a rate of ________% per month. ____________________________ Authorized By (Please Print) _____________________________ ___________ Signature Date 2001 © American LegalNet, Inc.
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