Cooney Technologies - Credit Application

Ownership
Ownership Type

Sole ProprietorshipLimited PartnershipGeneral PartnershipCorporation
Owners name
In business since
Type of business
Accounts Payable Contact
Accounts Payable Contact Name
Phone
Email
example@example.com
Fax
Please send invoices via

EmailUS MailFax
Email to Send Invoices To
example@example.com
US Mail Address to Send Invoices To

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Fax to Send Invoices To
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Principal Trade References
Reference 1
Name
Contact
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Reference 2
Name
Contact
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Reference 3
Name
Contact
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Reference 4
Name
Contact
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Cooney Coil payment terms is Net 30 days. Any customer whose account is more than 30 days past due will be placed on credit hold until the account is current. By signing this credit application, the applicant certifies that the information contained herein is complete & accurate, and the person executing this agreement has authority to bind the customer and is authorized by the customer to enter into/agree to the terms & conditions located @ https://www.cooneytechnologies.com/support/
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Send completed credit application to bezzy@cooneycoil.com
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Credit Application