Savannah (912) 228-5830 ~ Charleston(843) 278-2646 ~ Fax (843) 278-8038.
CNC CREDIT APPLICATION.
DATE: ______
COMPANY NAME: ______SHIP TO: ______
MAILING ADDRESS: ______ADDRESS: ______
PHYSICAL ADDRESS: ______CTY / ST. / ZC: ______
CTY / ST. / ZC: ______PHONE #: ______FAX #: ______
PHONE #: ______FAX #: ______ATTN: ______
AUTHORIZED BUYER:______
*SPECIAL DELIVERY INSTRUCTIONS: ______
______
COMPANY LEGAL ENTITY IS: (Check One.)
PROPRIETORSHIP.OWNER: ______
PARTNERSHIP.AUTHORIZED BUYER: ______
CORPORATION.HOW LONG IN BUSINESS: (Yrs.) (Mos.)
STATE ID #: ______FEDERAL ID #: ______
RESALE LICENSE #: ______STATE: ______
TYPE OF BUSINESS: ______
*TAX-EXEMPT #: ______CODE #: ______IS MERCHANDISE FOR RESALE? : YES NO. (Circle One.)
BANKING REFERENCES:
BANK NAME: ______BANK NAME: ______
ADDRESS: ______ADDRESS: ______
CITY / ST. / ZC: ______CITY / ST. / ZC: ______
BANK OFFICIER: ______BANK OFFICIER: ______
ACCOUNT #: ______ACCOUNT #: ______
LOANS: YES NO. (Circle One.)LOANS: YES NO. (Circle One.)
PHONE #: ______FAX#: ______PHONE #: ______FAX #: ______
TRADE REFERENCES: (3) REQUIRED.
COMPANY NAME: ______VENDOR CONTACT: ______
ADDRESS: ______
CTY / ST. / ZIP: ______
PHONE #: ______FAX #: ______CREDIT ESTABLISHED: ______
ACCT#:______TERMS: ______CREDIT LIMIT: ($) ______CURRENT AMT. ON ACCT: ($)______
COMPANY NAME: ______VENDOR CONTACT: ______
ADDRESS: ______
CITY / ST. / ZIP: ______
PHONE #: ______FAX #: ______CREDIT ESTABLISHED: ______
ACCT#: ______TERMS: ______CREDIT LIMIT: ($) ______CURRENT AMT. ON ACCT: ($) ______
COMPANY NAME: ______VENDOR CONTACT: ______
ADDRESS: ______
CITY / ST. / ZIP: ______
PHONE #: ______FAX #: ______CREDIT ESTABLISHED ______
ACCT#: ______TERMS: ______CREDIT LIMIT: ($) ______CURRENT AMT. ON ACCT: ($)______
*CNC is authorized by this signed document to contact any of the above references. It is understood that any of the information obtained will be used solely for the purpose of granting CNC credit terms to our customers only. All CNC Customer credit information is considered confidential and will not released, copied or redistributed to any parties under any circumstances. Upon approval of this credit application, I agree to pay for all merchandise, using CNC terms, All approved Credit Cards, COD - Cash, Money Order, Cashier’s Check, approved Personal or Company Check.
AUTHORIZED SIGNATURE: ______DATE: ______
PRINT NAME: ______