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CREDIT APPLICATION FORM

COMPANY NAME: ________________________ Billing Address: ___________________________
____________________________
Shipping Address: ________________________
________________________
Telephone: ______________________________ Telephone: ______________________________
Fax: ____________________________________ Fax: ____________________________________
Federal tax ID (GST No): ____________________

Type of Business: Manufacturer/Fabricator/OEM Wholesaler/Distributor

Other (Specify) ______________________

Years Established: __________

Bank: ___________________________________ Address: ________________________________

Contact person: ___________________________ Title: __________________________________
Account Number: __________________________
Telephone: _______________________________ Fax: ___________________________________
TRADE REFERENCES:
1) Company Name: _________________________ Tel: _______________ Fax: _______________
2) Company Name: _________________________ Tel: _______________ Fax: _______________
3) Company Name: _________________________ Tel: _______________ Fax: _______________
Date: ___________________________________ Signature: ____________________________

INTERNAL USE ONLY

Sold Since High Credit Now Owing Last Sale Terms Payment Pattern
Ref 1) __________ __________ __________ __________ __________ _____________
Ref 2) __________ __________ __________ __________ __________ _____________
Ref 3) __________ __________ __________ __________ __________ _____________
Amount Approved: $__________ Date: ___________ Manager Approval: ___________
TERMS: Net 30 Days Special Terms of: ______________________________
63 McIntyre Place Phone & Fax Online
Unit #7 & 14 +1 (519) 748-2287 www.rrforklift.com
Kitchener, Ontario +1 (519) 748-2297 parts@rrforklift.com
N2R 1J5 Submit by Email