Danica Credit Terms Application

Danica Credit Terms Application
Hello!

Thank you for your interest in applying for credit terms with Danica.

Here are a few things to note before you begin:

1. Credit Card details are required with opening orders.

2. Opening order charges and all subsequent order charges will be processed on the date of shipping unless terms have been requested and approved.

3. Requested & approved term charges will be processed according to the new invoice terms and conditions.

To apply for credit terms, please fill out the form below and someone from our credit department will follow up with you.
Account Payable Contact

First NameLast Name
Account Number *
Company Name*
Address Type*
Country*
Unit Number
Street Address*
Postal/Zip Code*
City*
Province*
Province
State*
State
*

I would you like to apply for Credit Terms
CREDIT TERMS APPLICATION

Someone from our accounting department will follow up with you via email or phone to let you know if you have been approved
TRADE REFERENCES

Please provide at least two references to apply for credit terms
Company Name*
Phone Number*
Fax Number
Email Address*
Company Name*
Phone Number*
Fax Number
Email Address*
Company Name*
Phone Number*
Fax Number
Email Address*
FINANCIAL REFERENCE

Please provide one full reference to apply for credit terms
Bank Name
Branch Number
Account Number
Contact Name
Contact Phone Number
Please enter a valid phone number.
Contact Email
example@example.com
APPROVAL
*

We hereby jointly and severally agree to pay our account according to your terms of sale, and to pay interest at a rate of 2% per month on all amounts in arrears in addition to attorney fees and court costs.
Name*
Title
Date*

MonthDayYear
Date
Should be Empty:

Danica Credit Terms Application

CREDIT TERMS APPLICATION

TRADE REFERENCES

FINANCIAL REFERENCE

APPROVAL