• JK Customer Information Form

  • APPLICANT INFORMATION

  • COMPANY INFORMATION

  • BANK REFERENCE

  • TRADE REFERENCES

  • FINANICAL INFORMATION

  • INVOICE DELIVERY

  • All invoices are emailed unless a paper copy is requested. To receive a paper copy of your invoice mailed to you, please fill out the billing information below.

  • Agreement

    By signing below, we declare that the above information is true, correct and complete to the best of our knowledge.If we are granted credit, we agree to pay all invoices within 30 days of the date of the invoice. We are authorizing JKProducts & Services, Inc. to contact the trade references listed on this application and our bank as needed for thepurpose of determining credit worthiness.
  • Clear
  •  -  -
    Pick a Date
  • Clear
  •  -  -
    Pick a Date
  • DISCLAIMER: Please be advised that completion of this application does not guarantee the provision of payment terms. JK in its sole discretion may request additional information for the consideration of payment terms associated with orders greater than $5,000.00.

     

    411 WEST WASHINGTON AVENUE, SUITE B | JONESBORO, AR 72401 | Toll-Free: 888.771.0996 | Fax: 870.935.3618

  • Should be Empty: