Business Contact Info
Credit Application for ZHL Business Account
Company Name
*
Phone Number
*
Fax Number
E-mail
*
example@example.com
Company Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Federal ID Number
*
Company Type
*
Sole Proprietorship
Partnership
Corporation
LLC
Other
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Business and Credit Info
Accounts Payable Contact
*
First Name
Last Name
Accounts Payable Phone
*
Accounts Payable Fax
E-mail
*
example@example.com
Company to Bill Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Bank Name
*
Bank Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Bank Phone Number
*
Savings Account #
Checking Account #
Other Account #
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Business References
Reference 1: Company Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Fax Number
E-mail
example@example.com
Type of Account
Reference 2: Company Name
Address 2
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number 2
Fax Number 2
Type of Account 2
Reference 3: Company Name
Address 3
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number 3
Fax Number 3
Type of Account 3
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Agreement
(By checking these boxes you are agreeing to our terms - should you have any questions please contact us)
Agreement and Terms
*
ALL INVOICES ARE DUE UPON RECEIPT.
Agreement and Terms
*
Claims arising from invoices must be made within 3 business days of the invoice date.
Agreement and Terms
*
By submitting this credit application, you authorize us to make inquires into the banking and business references that you provided.
Signature
Digital Signature Date
*
-
Month
-
Day
Year
Date
Signature
Digital Signature Date 2
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: