New Partner Application
Company Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Title
*
Requested Credit Limit
*
Net 30 Terms
*
Acknowledgement of Net 30 Terms
Billing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email to Receive Invoices
*
example@example.com
Fed ID#
*
AP Contact Name
*
First Name
Last Name
AP Contact phone
*
Format: (000) 000-0000.
AP Email
*
example@example.com
Brands of Interest
*
Ambir
Canon
Digitech Systems
Epson
Kodak Alaris
Pharos
OpenText
Reftab
rfIDEAS
Scriptel
ShelterZoom
Tungsten Automation
Upland
Vasion
Visioneer
Wacom
Xerox
Other
Reseller Certificates and Other Supporting Documents
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List 1 to 3 Trade References
*
Include company name, phone number and email
Terms and Conditions
By clicking the submit below, or signing with original signature, I hereby represent that I am authorized to submit this application and bind the business identified in this application, and that the information provided is for the purpose of obtaining credit and is warranted to be true. The business identified in this application acknowledges that this request is for the extension of credit for commercial purposes only and is not intended for the extension of credit for personal, family or household purposes. In order to protect individual identities, unless an individual is intending to act as a guarantor for purposes of securing credit and is required to provide guarantor information on this application, no personally identifying information (i.e. Social Security#, drivers license#, bank account information, etc.) should be provided. The business identified in this application hereby authorizes all banks, financial institutions, trade reference sources, credit reporting agencies and others to release credit information. In the event of a conflict, the terms and conditions set forth above shall control over any terms and conditions set forth below. This application is submitted for the purpose of obtaining credit with Cranel, Incorporated and is warranted to be true. By signing this application the undersigned acknowledges that he/she is authorized to execute this application and to obligate the company to make payment in full for all amounts due according to invoice on or before the net date due. Additionally, the undersigned will be responsible for all collection costs and attorney fees, with or without lawsuit, in order to collect any delinquent moneys. The undersigned hereby authorizes Cranel, Incorporated to make such inquiries (corporate/personal) as are necessary to obtain credit information and authorizes the bank(s) of record to release information regarding accounts.
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