PTS Electronics Corporation - Credit Application
Company:
Billing Address:
City:
State:
Zip:
Shipping Address:
City:
State:
Zip:
Telephone:
Fax:
Email:
Type of Business:
Date Established:
Type of Entity: Proprietorship
Partnership
Corporation
Other
If Incorporated:
State of Incorporation:
Year of Incorporation:
Please include tax exempt certificate, if applicable
Key Management Members and Owners
Titles:
Percentage Ownership:
Bank:
Address:
City:
State:
Zip:
Phone:
Officer:
Account Number:
Three Trade References, Addresses and Phone Numbers
(Two major suppliers and one smaller supplier)
Reference #1
Name:
Account Number:
Estbl.:
Address:
City:
State:
Zip:
Phone:
Fax:
Contact:
Reference #2
Name:
Account Number:
Estbl.:
Address:
City:
State:
Zip:
Phone:
Fax:
Contact:
Reference #3
Name:
Account Number:
Estbl.:
Address:
City:
State:
Zip:
Phone:
Fax:
Contact:
Estimated monthly purchases:
Credit line requested:
The above information is provided for the purpose of extending credit to our company on your terms of Net 30 from invoice date. To the best of our knowledge and belief, the information is accurate and may be relied upon in making your credit decision. We authorize our bank and suppliers to furnish you any information necessary to complete your evaluation of our credit history.
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Copyright © 2002 PTS Corporation, All Rights Reserved
No duplication in part or full without written permission
