Business Credit Application Form

Chic Pistachio New Account Form
Company Information
Name of Company
Type of Business
Tax I.D. Number
In Business Since :

MonthDayYear
Date
JBT #
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Store Phone Number

Area CodePhone Number
Billing Contact Info

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Marketing Contact Info

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Bank References

Bank and trade references only need to be completed for consideration for terms. Please note that this will add 3-5 business days to processing time. Credit card prepayments do not require the below to be completed and will process faster. For credit card payments, you can access our authorization form through this address. https://www.dropbox.com/scl/fi/z14ruccf3mfowhjz7srny/Credit-Card-Authorization-Form-1.pdf?rlkey=ev5plg8gj1vqavgvkpunzfaek&dl=0
Institution Name
Contact Person

First NameLast Name
Contact Person Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Trade References
Company Name
Contact Name

First NameLast Name
Phone Number

Area CodePhone Number
Account opened since

MonthDayYear
Date
Current Balance
Credit Limit
Company Name 2
Contact Name

First NameLast Name
Phone Number

Area CodePhone Number
Account opened since

MonthDayYear
Date
Credit Limit
Current Balance
Financial Information
Company Total Assets
Annual Net İncome
Amount of Credit Requested
Terms & Conditions Signature authorizes us to check related business records including JBT ratings, company credit reports and trade / bank references provided.
Signature

Clear
You can easily attach and submit your completed saved Credit Card Authorization Form here. Also, we need a copy of your state tax resale certificate prior to shipping your first order. Please upload here for faster processing or email to customerservice@aniahaie.com.

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Chic Pistachio New Account Form

Company Information

Bank References

Trade References

Financial Information