CREDIT APPLICATION FOR A BUSINESS ACCOUNT
 

Business Contact Information

Your Name

Company Name

Phone

Fax

e-mail

Registered Company Address

City

State

Zip

Date business commenced

Sole proprietorship

Partnership

Corporation

Other

Business and Credit Information

Primary Business Address

City

State

Zip

How long at current address?

Telephone

Fax

e-mail

Bank Name

Bank address

City

State

Zip

Phone

Type of Bank Account

Account number

Savings

Checking

Other

Business and/or Trade References

(1) Company Name

Address

City

State

Zip

Phone

Fax

e-mail

Type of Account

(2) Company Name

Address

City

State

Zip

Phone

Fax

e-mail

Type of Account

Agreement

1.  All invoices are to be paid 30 days from the date of the invoice
2.  Claims arising from invoices must be made within 7 working days
3.  By submitting this application, you authorize Grandt Line Products to make enquiries to the banking, savings, business, and/or trade references you have supplied

Signature/Title

Date