Whitmore Business Application

Whitmore Business Application

Please complete the following to apply for a Business Application. If at any time you have questions about any of the fields below. Please contact Sue (sthompson@whitmoreace.com or 815-476-7731) at our Main Office.
Applicant Information
Name *

First Name Last Name
E-mail *
Your Company Information
Business Name *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Ownership Type *

Corporation Partnership Sole Proprietorship
Federal ID Number
Tax Exempt *

Yes No
If yes
Upload copy of Federal Exemption Letter
Ace Rewards Member *

Yes No
Member Number
Will this be for resale?

Yes No
If yes
Upload a copy of certificate of resale
Briefly describe the nature of your business *
Accounts Payable Information
Name *

First Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
Fax Number

Area Code Phone Number
Would you also like to apply for credit account? *

Yes No
Owner Information
Name

First Name Last Name
Phone Number

Area Code Phone Number
E-mail
Financial Information
Bank Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Bank Officer *

First Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
Fax Number *

Fax Number
Business References
Reference 1 *

Business Name

Address

City State

Zip Code
Phone Number *

Phone Number
Fax Number *

Fax Number
Reference 2 *

Business Name

Address

City State

Zip Code
Phone Number *

Phone Number
Fax Number *

Fax Number
Reference 3 *

Business Name

Address

City State

Zip Code
Phone Number *

Phone Number
Fax Number *

Fax Number
Do you require a purchase order? *

Yes No
Persons Authorized to Charge to the Account
Please list first and last names
Must authorized users show ID at every purchase? *

Yes No
All statements will be emailed to the the Accounts Payable email address above. Would you like an invoice emailed after every charge?

Yes No
I Certify that all the information on this form is correct. I fully understand the credit terms and agree to the proper payment in consideration of extended credit.
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Whitmore Business Application

Applicant Information

Your Company Information

Accounts Payable Information

Owner Information

Financial Information

Business References