Eagle Door & Hardware - Credit Application

Eagle Door & Hardware - Credit Application
If you wish to purchase COD basis - please fill out all information up to the trade references section
Organization Information
Company Name
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Shipping Address if different from mailing

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Accounts Payable Contact Person
Office Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Fax Number

Area CodePhone Number
E-mail
ex: john@smithdoors.com
Type of Business
City Business License #
Date Company Established

MonthDayYear
Type of Purchase Order
Resale # if applicable
Bond #
Type of Organization
ex: LLC
List the Officers of the Company: Owner or Partners
Bank Information
Bank Name
ex: Bank of America
Bank Address/Contact

Address

Contact Person

Account #

Phone #
Credit Line Amount Requested
ex: $10,000
TRADE REFERENCES (4 required)
Business Name
Contact Person

First NameLast Name
Phone Number

Area CodePhone Number
Account #
Business Name
Contact Person

First NameLast Name
Phone Number

Area CodePhone Number
Account #
Business Name
Contact Person

First NameLast Name
Phone Number

Area CodePhone Number
Account #
Business Name
Contact Person

First NameLast Name
Phone Number

Area CodePhone Number
Account #
By clicking the SUBMIT button on this form you are herein make application to EAGLE DOOR AND HARDWARE for credit and agree to all terms set forth below:

If credit is granted, we hereby agree to pay in full within the prescribed terms of 1% 15/net 30 days. We understand all invoices 30 days past due are subject to a finance charge of 1 1/2% per month until paid. Payment terms are subject to change without notice. In the event payment is not made and this account is referred to an attorney and/or a collection agency, we agree to pay all costs of collection of such amounts due including collection fees, attorney fees, and court costs incurred. We give our permission to EAGLE DOOR AND HARDWARE and/or its agents to verify the information stated herein.

O:805-463-3667 F:805-239-1851 (P.O. Box 1476 Paso Robles CA 93447)

Eagledoorandhardware@gmail.com
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