Credit Application

 

General Information

 

Company name:______________________________________                                                                                        

 

Type of Business:_____________________________________

 

Mailing Address:___________________________________________________________________

 

Delivery Address:___________________________________________________________________

 

City/State/Zip:_____________________________________________________________________

 

Phone #:_____________________________________                                                                             

 

Fax #:_______________________________________

 

Web Address:_____________________________________________________________________

 

Years in Business:_______________ Federal Tax ID #:_____________________     

 

Purchase Orders Required:    Yes/No

 

Email / Fax invoices?  (Provide email address/fax #) ____________________________

 

Principal Contacts

 

Owners Name:___________________________________________________________ Ext._______

 

Accts. Payable Contact:____________________________________________________ Ext._______

 

 

 

 

 

 

 

 

 

 

 

Trade References

 

Name                                     Address                                          Phone                          Fax

 

1)_______________________________________________________________________________

 

2)_______________________________________________________________________________

 

3)_______________________________________________________________________________

 

Banking Information

 

Name                                           Address                                         Phone                           Fax

 

_________________________________________________________________________________

 

 

Owner/Officer Signature:____________________________ Title:_______________________ Date:_______________

 

 

Please return completed form via email or fax.  Any questions, please feel free to contact me.

 

Thank You,

 

 

Vanessa Degnan
Accounts Payable/Receivable Specialist

262.781.2770 ext. 214
Fax: 262-781-2208

Vanessa@tartansupply.com