COMMERCIAL CREDIT APPLICATION

COMMERCIAL CREDIT APPLICATION

Confidential Credit Application Agreement
Name of Business and Billing Address Details
Date

MonthDayYear
Date
Legal Name of Company*
Trade Name (If Any)
Street Address*
City*
Province*
Email Address
example@example.com
Telephone Number*
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
GST #*
Postal Code*
Closest Office*
Head Office Address (If Different than Biling Address)
Street Address
City
Province
Postal Code
Telephone Number
Please enter a valid phone number.
Business Information
Form of Business (Check Appropriate Option)*

ProprietorshipPartnershipCorporationOther
If Other, Describe
Line of Credit Desired*
Annual Sales*
No. of Years in Business*
Estimated Net Worth*
Financial Statement Available:*

YesNo

Full Name and Address of Owners and Partners:*

	NAME	ADDRESS
1.
2.
3.
4.

Other Company Information
Name of Parent Company & Affiliation (If Any)
Nature of Business*
Day or Month Business Started*
Number of Employees*
Premises (Check Appropriate Option)*

OwnedRented
Bank Reference
Bank Name*
Branch Number*
Address*
Bank Contact*
Telephone Number*
Please enter a valid phone number.
Account Number*
Required Trade References (3):
Reference 1: Company Name
Reference 1: Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reference 1: Phone Number
Please enter a valid phone number.
Reference 1: Email Address
example@example.com
Reference 1: Line of Credit ($)
Reference 2: Company Name
Reference 2: Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reference 2: Phone Number
Please enter a valid phone number.
Reference 2: Email Address
example@example.com
Reference 2: Line of Credit ($)
Reference 3: Company Name
Reference 3: Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reference 3: Phone Number
Please enter a valid phone number.
Reference 3: Email Address
example@example.com
Reference 3: Line of Credit ($)

Required Trade References*

	Company Name	Address	Telephone Number	Email Address	Line of Credit ($)
1.
2.
3.

tradeReferenceCompany1
tradeReferenceEmail1
tradeReferenceCompany2
tradeReferenceEmail2
tradeReferenceCompany3
tradeReferenceEmail3

Additional Trade References

	Company Name	Address	Telephone Number	Email Address	Line of Credit ($)
1.
2.
3.

CREDIT TERMS:

** All accounts rendered by Border Paving Ltd. are to be paid within 30 days from invoice date unless otherwise contracted.

** Failure to settle accounts as required will be considered sufficient cause for immediate cancellation of credit.

** A service charge of 2% per month (24% per annum) will be paid by the customer on all amounts over these terms.
Name*

First NameLast Name
Title
Signature*

Clear
From Email Name
From Email Address
Should be Empty: