Spaenaur

APPLICATION FOR CREDIT FAX FORM TO (519) 744-3240
GENERAL INFORMATION INQUIRIES CALL (519) 744-6305 OR (800) 263-5367
LEGAL BUSINESS NAME
OPERATING AS
NAME OF PARENT (IF SUBSIDIARY)
ADDRESS
PHONE ( ) FAX ( ) EMAIL WEBSITE
ONTARIO SALES TAX EXEMPT? q YES q NO GOODS AND SERVICES TAX EXEMPT? q YES q NO
BUSINESS DETAILS
LEGAL STATUS q CORPORATION q PARTNERSHIP q SOLE PROPRIETOR SIC CODE
NUMBER OF YEARS IN BUSINESS TYPE OF BUSINESS
PRODUCTS SOLD
ANNUAL REVENUE LAST YEAR
PRESIDENT/PRINCIPAL OWNER
HOME ADDRESS HOME PHONE ( )
OFFICER/PARTNER
HOME ADDRESS HOME PHONE ( )
OFFICER/PARTNER
HOME ADDRESS HOME PHONE ( )
HAS THE BUSINESS OR ANY OF THE ABOVE PEOPLE BEEN INVOLVED IN BANKRUPTCY? IF YES, PLEASE EXPLAIN.
BANK REFERENCE
BANK NAME
ACCOUNT MANAGER
ADDRESS PHONE ( )
TRADE REFERENCES
SUPPLIER NAME FAX ( )
PHONE ( ) ADDRESS
SUPPLIER NAME FAX ( )
PHONE ( ) ADDRESS
SUPPLIER NAME FAX ( )
PHONE ( ) ADDRESS
CREDIT LIMIT REQUESTED ____________________
TERMS
1. Any of the above named owners/officers are authorized to purchase on this account as well as the following people:
a. ____________________________________ c. ____________________________________
b. ____________________________________ d. ____________________________________
2. All accounts are due 30 days following the date of invoice. A service charge of 1.5% per month (18% per annum) may be added to overdue amounts.
3. If business is a partnership, all debts are incurred jointly and severally.
4. Undersigned certifies all information is true and correct.
5. Undersigned personally guarantees all debts incurred in the business name. This guarantee shall be a continuing guarantee to secure whatever balance may be
due from time to time.
Authorized Signature__________________________________
Title______________________________________________
Print Name________________________________________ Date_________________ REV 07/23/2001