3BG Terms Application

3BG Credit Application

Credit Terms and Agreement: Standard terms are Net 30 from the date of ship. Returned materials will be subject to a restocking charge. Returned checks are subject to return check fees. When Credit is extended, it is contingent upon prompt payment, according to the agreed upon terms and will be restricted by a credit limit – to be determined by the Accounts Receivable Department. We will review your account periodically. We can adjust the terms and amount if in good standing as needed. Credit privileges can be withdrawn at any time without notification if the account goes past due.
Company Information

Please fill out your company's information
Legal Company Name*
DBA
Date Business Opened

MonthDayYear
Date
Federal Tax ID #*
Type of Business

CorporationPartnershipSole-ProprietorshipLLCOther
Credit Limit Requested
Estimated Annual Sales*
Expected Monthly Purchases ($)*
Primary Purchasing Contact*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Secondary Purchasing Contact

First NameLast Name
Phone Number

Area CodePhone Number
E-mail
example@example.com
Name of Person Authorized to Order Material

First NameLast Name
Accounting Dept Contact*

First NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
Invoicing Email (if Different)
example@example.com
Statement Email (if Different)
example@example.com
Do require a PO Number?*

YesNo
Company Billing Address*

Street Address

CityState

Zip Code
Company Shipping Address*

Street Address

CityState

Zip Code
Shipping Carrier Preference

UPSFedExOther
Shipping Account Number
Freight Account Number
Freight Company
Tax Exemption Information

Please indicate if you are tax exempt. If you are tax exempt, you must attach your tax exempt certificate.
ARE YOU TAX EXEMPT?*
ATTACH YOUR TAX EXEMPTION CERTIFICATE HERE

Browse Files

Cancelof
Reference Information

Select "Yes" if you want to attach your references OR select "No" to fill in the corresponding reference information
I PREFER TO EMAIL/ATTACH MY REFERENCES AND BANKING INFORMATION*
Browse Files

Cancelof
Reference #1
Company Name*
Address Information*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail
FAX

Area CodePhone Number
Reference #2
Company Name*
Address Information*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail
FAX

Area CodePhone Number
Reference #3
Company Name*
Address Information*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail
FAX

Area CodePhone Number
Bank Reference
Bank Name*
Bank Officer Name
Account Number*
Address Information*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail
FAX

Area CodePhone Number
Consumer Credit Authorization

I hereby certify that the information contained herein is complete and accurate. This information hasbeen furnished with the understanding that it is to be used to determine the amount and conditions ofthe credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this creditapplication to release necessary information to the company for which credit is being applied for inorder to verify the information contained herein.
Applicant's Name:*

First NameLast Name
Applicant Signature: (Signature must be by an authorized Officer, Partner, or owner of the business)*
Enter the message as it's shown (Click the refresh button if image does not appear)*
For questions please contact our Accounts Receivable Department at AR@3bgsupply.com or by phone at 800-609-5205 x 9.
Should be Empty:

3BG Credit Application

Company Information

Tax Exemption Information

Reference Information

Reference #1

Reference #2

Reference #3

Bank Reference

Consumer Credit Authorization