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