APPLICATION FOR CREDIT WITH
A N B STATIONERY, INC.
12338 Ventura Blvd. Studio City, CA 91604
(800) 832-8909 (818)760 - 0244 fax : (818) 506-8210
e-mail : anb@anbstationery.com
internet : www.anbstationery.com
Fields marked with (
*
) are compulsory
.
NAME :
*
TELEPHONE :
*
ADDRESS :
*
NUMBER OF YEARS IN BUSINESS :
CITY :
*
STATE :
*
ZIP :
*
FAX:
E-MAIL:
*
THE FOLLOWING INFORMATION MUST BE COMPLETED IN FULL - ALL INFORMATION HELD IN STRICTIST CONFIDENCE
OWNERSHIP
FOR
CORPORATION
PARTNERSHIP
PROPRIETORSHIP
INCORPORATED WITHIN LAST 12 MONTHS
Name(President)
:
Address :
City :
State :
Zip Code :
Name(Secretary)
:
Address :
City :
State :
Zip Code :
Name(Treasurer)
:
Address :
City :
State :
Zip Code :
FINANCE
Bank Name :
Address :
CITY :
STATE :
Zip Code :
Telephone :
Accounts :
Bank Representative :
CREDIT REFERENCES
Name :
Address :
City :
State :
PHONE NO :
Name :
Address :
City :
State :
PHONE NO :
Name :
Address :
City :
State :
PHONE NO :
I(WE) CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT AND WE COMPLY WITH YOUR TERMS OF NET 30 DAYS UPON APPROVAL OF OPENING A CHARGE ACCOUNT, PAST DUE PAYMENTS MAY BE SUBJECT TO INTEREST CHARGES OR PAYMENT OF COLLECTION FEES.
Please enter your name to acknowledge that you have read the above and accept the same.
Date :
SIGNED :
REFERENCED CHECKED BY :
DATE :
REMARKS :
CREDIT APPROVED BY :
CREDIT DISAPPROVED BY :
DATE :