Credit Application

Note: To ensure quick processing of application, please complete all areas in detail and email back in PDF. Please type or print legibly. “ALL INFORMATION GIVEN WILL BE HELD IN STRICT CONFIDENCE.

Please Note: Until application has been approved, payment term will be on a prepaid basis. All 1st orders are prepaid.

Company Name (DBA)
Shipping Locations
Business Address
Business City
Business State
Business ZIP
Business Country
Business Phone
Business Website
Principal Contact Name
Email

Section 2: To be completed for sales order processing for new customers & credit limit increase for existing customers

Full Name of Owners – Partners – Officers	Title

Nature of Business
Buyer’s Name
Main Product to Order
Business Start Date
Name of Bank
Bank Address
Bank Account Number
Bank Phone
Credit Line Required

TRADE REFERENCES

Company	Contact Person	Email	Phone Number

Please complete IRS W-9 form and submit the document below

W-9 Form	https://www.irs.gov/pub/irs-pdf/fw9.pdf
Tax ID
Upload a File	File(s) size limit is 20MB.