Page 2

CREDIT APPLICATION

APPLICATION FOR CREDIT

COMPANY’S LEGAL NAME:________________________________________________________________________ MAILING ADDRESS ________________________________ CITY __________________ STATE______ ZIP _______ SHIPPING ADDRESS ________________________________ CITY __________________ STATE______ ZIP_______ PHONE ________________________ FAX ______________________ E-MAIL _____________________________ ARE YOU REQUIRED TO PAY SALES TAX? YES_______ NO________ TAX EXEMPT #_________________________ INCLUDE COPY OF EXEMPTION CETRIFICATE TO BE CONSIDERED TAX EXEMPT DATE COMPANY AQUIRED______________________ TYPE OF BUSINESS ______________________________ NUMBER OF YEARS IN BUSINESS ________________ OWNERS NAME_________________________

PARTNER OR SPOUSE______________________________

PHONE ________________________________

PHONE__________________________________________

ADDRESS ______________________________

ADDRESS________________________________________

CITY______________ STATE____ ZIP_________

CITY________________ STATE_____ ZIP______________

REQUESTED CREDIT LINE __________________________ TRADE REFERENCE: CHARGE ACCOUNTS ONLY – FULL NAME, FAX OR E-MAIL ADDRESSES NAME

FAX

E-MAIL

1.______________________

_____________________

_________________________________

2.______________________

_____________________

_________________________________

3.______________________

_____________________

_________________________________

The undersigned hereby agrees to abide by the selling terms of American Copper & Brass, LLC. (1%30, NET 45 days from the date of the invoice. Late payments will be charged a 1.5% late fee (min $5.00) starting the 46th day. (18% per annum).). Applicant consents to jurisdiction and venue in Coldwater, MI and agrees to pay any collection costs incurred to collect the account balance, including reasonable attorney’s fees. The undersigned warrants that the information submitted is true and correct. American Copper & Brass, LLC is authorized to contact the credit references listed above.

________________________________________ NAME/ TITLE

________________________________________ NAME/TITLE

________________________________________ DATE

________________________________________ DATE

Profile for American Copper and Brass, LLC

080119 American Copper and Brass Product Catalog  

080119 American Copper and Brass Product Catalog