CREDIT APPLICATION FOR A BUSINESS ACCOUNT

BUSINESS CONTACT INFORMATION

Title: Fed ID: Sales Tax:
Company name:
Phone: Fax: E-mail:

Registered company address
City: State: Zip:

Date business commenced:
Business type: Sole ProprietorshipPartnershipCorporationOther

BUSINESS AND CREDIT INFORMATION

Primary business address
City: State: Zip:
How long at current address?
Phone: Fax: E-mail:

Bank name:
Bank address: Phone:
City: State: Zip:

Type of account Account Number
Savings
Checking
Other

BUSINESS/TRADE REFERENCES

Company name:
Company address
City: State: Zip:
Phone: Fax: E-mail:

Company name:
Company address
City: State: Zip:
Phone: Fax: E-mail:

Company name:
Company address
City: State: Zip:
Phone: Fax: E-mail:

Type of account:

AGREEMENT

  1. All invoices are to be paid 30 days from the date of the invoice.
  2. Claims arising from invoices must be made within seven working days.
  3. By submitting this application, you authorize Performance Partner Inc. to make inquiries into the banking and business/trade references that you have supplied.

SIGNATURES

Name | Name
Date | Date