Company Name:

Address:

City:
 
Postal Code: 
 
Phone:
 
FAX: 
 

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Type of business:

How long in business:

Tax number

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PARTNERS OR CORPORATE OFFICERS

Name Title Phone	Name Title Phone
Name Title Phone	Name Title Phone

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BANK REFERENCES

Bank Name and Address Account number Contact Name & Phone	Bank Name and Address Account number Contact Name & Phone
Bank Name and Address Account number Contact Name & Phone	Bank Name and Address Account number Contact Name & Phone

TRADE REFERENCE

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IMPORTANT CONDITION OF SALE

FIRST TRANSACTION IS C.O.D., FUTURE ORDERS WILL BE 2% DISCOUNT IF PAID WITHIN 10 DAYS NET 20 DAYS.

I/WE HEREBY AUTHORIZE FS CONTROL SERVICES INC. TO CONDUCT WHAT CREDIT INVESTIGATION THAT THEY FEEL IS NECESSARY ON THE ABOVE COMPANY.

FOR ACCOUNTS OVERDUE IN EXCESS OF 90 DAYS. FUTURE ORDERS WILL NOT ВЕ PROCESS UNTIL ACCOUNT IS BROUGHT UP ТО DATE. (CURRENT)

I/WE HEREBY AGREE ТО PAY ALL COST OF COLLECTION SHOULD SUCH ACTION ВЕ NECESSARY.

I certify that the above information is true. This information is to be used only for opening an account.