Credit Application Form

CREDIT APPLICATION FORM

    Company Name

    Address

    City

    Country

    Phone #

    Email

    Province/Region

    Postal Code

    Fax #

    Website

    Type of Business

    # of Years

    Purchasing Contact Name

    Accounts Payable Contact Name

    Email

    Email

    Ext

    Ext

    Email Invoices?

    HST#

    BANK INFORMATION:

    Bank Name

    Bank Phone #

    Transit #

    Bank Address

    Bank Fax #

    Account #

    CREDIT REFERENCES:

    Reference 1

    Reference 1 Phone #

    Reference 1 Email

    Reference 2

    Reference 2 Phone #

    Reference 2 Email

    Reference 3

    Reference 3 Phone #

    Reference 3 Email

    We/I make this application for a charge account and give Royal Containers Ltd. authorization to obtain a report of business information on the principals of the company through a credit agency for the purpose of opening this account and monitoring it for this business relationship. We/I authorize the exchange of business on an ongoing basis with credit bureaus and trade suppliers in order to protect and ensure completeness of the information and to maintain the integrity of the credit-granting system. We/I authorize the co-operation with local, provincial, and national authorities in the investigation of unlawful and improper activities in order to protect both parties from fraudulent transactions. We/I authorize the disclosure of business information where necessary to protect your interests and ours.

    Signature of Authorized Signing Officer

    Name of Authorized Signing Officer

    Today's Date (MM/DD/YY)


    (Form must be signed or it will not submit)