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CREDIT
APPLICATION
Billing Address
Shipping Address
Legal Company Name of Applicant
(Not required if same as Billing Address)
Name
*
:
Name:
Address
*
:
Address:
City
*
:
City:
Postal Code
*
:
Postal Code:
Telephone
*
:
Telephone:
Fax No.
(Accounts Payable)
*
:
Fax No.:
Corporate Information
Indicate Type of Business
*
:
Corporation
Sole Proprietorship
Partnership
Other
Other
(Please Specify)
:
No. of Office Employees
*
:
Nature of Business
*
:
No. Years in Business
*
:
Name of Owner/Principal
*
:
Purchase Order Required
*
:
Yes
No
Name of Buyer
*
:
Email
*
:
A/P Contact
*
:
A/P Email
*
:
Do you require our office products catalogue?
*
Yes
No
Estimated annual office supply purchases
*
: $
How will you purchase the majority of your products?
*
In Store
Online
Phone/Fax/Email
Which types of products will you be purchasing?
*
Printer/Computer Supplies
Paper Products
General Office Supplies
Janitorial/Breakroom Supplies
Furniture
All of the Above
If Company is Less Than One Year Old - Please Complete
Name & Addess of Principals (Owners)
Name:
Name:
Title:
Title:
Home Address:
Home Address:
City:
Postal Code:
City:
Postal Code:
Please Complete All Credit References
1) Name of Bank
*
:
Branch Address
*
:
Telephone No
*
:
Account No
*
:
2)Trade References
A) Name of Business
*
:
Address
*
:
Telephone No.
*
:
Fax No.:
B) Name of Business
*
:
Address
*
:
Telephone No.
*
:
Fax No.:
Certification of Application
I certify that the information on the application is correct and hereby apply for a credit account from Monarch Office Supply Inc. I agree that all accounts are due and payable net 30 days. Interest charged at 2% per month (24% per annum) on all overdue accounts. I hereby authorize the person or firm to whom this application is made, any credit bureau or reporting agency to investigate the references herein listed, or statements, or other statements, or other data obtained pertaining to my credit or financial responsibility.
Name
*
:
Date:
Fri May 18 2012
Title
*
:
I have read an understand the
privacy policy
*
I agree with terms and conditions above
*
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