Fillable BUSINESS CONTACT INFORMATION BUSINESS AND CREDIT INFORMATION CREDIT

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BUSINESS CONTACT INFORMATION BUSINESS AND CREDIT INFORMATION CREDIT

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Whittlesey Landscape Supplies & Recycling, Inc
CREDIT APPLICATION FOR A BUSINESS ACCOUNT
BUSINESS CONTACT INFORMATION
Parent Company Name:
DBA Company name:
Payment Contact Name:
E-mail:
Phone:
Fax:
Requesting Terms Net Account: 30 days / 15 days / 10 days
Credit Line Requested:
$
Mailing/Billing Address:
City:
State:
Zip Code:
BUSINESS AND CREDIT INFORMATION
Physical/Shipping Address:
City:
State:
Zip Code:
How long at current address?
Telephone:
Fax:
E-mail:
Bank name:
Bank address:
Phone:
City:
State:
Zip Code:
Type of account:
Account number:
Savings
Checking
Other
BUSINESS/TRADE REFERENCES
Company name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
Type of account:
Company name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
Type of account:
Company name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
Type of account:
AGREEMENT
1. All invoices are to be paid within Account Terms.
2. Invoice disputes must be made within five working days.
3. By submitting this application, you authorize Whittlesey Landscape Supplies & Recycling, Inc to make inquiries to the bank and
business/trade references that you have supplied.
SIGNATURE
Signature:
Printed Name:
T
itle: Date:
Mail To: Accounts Receivable
Whittlesey Landscape Supplies
PO Box 1119
Round Rock, Texas 78680
(512) 251-5710
Email to: Accounts Receivable
ar@989rock.com
Federal ID# or EIN Number:
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BUSINESS CONTACT INFORMATION BUSINESS AND CREDIT INFORMATION CREDIT

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Completed 21 December 2021

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