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 NameLast Name
E-mail*
Your Company Information
Business Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Ownership Type*

CorporationPartnershipSole ProprietorshipOther
Federal ID Number
Tax Exempt*

YesNo
If yes

Upload a File
Upload copy of Federal Exemption Letter Cancelof
Ace Rewards Member*

YesNo
Member Number
Will this be for resale?

YesNo
If yes

Upload a File
Upload a copy of certificate of resale Cancelof
Briefly describe the nature of your business*
Accounts Payable Information
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Fax Number

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

YesNo
Owner Information
Name

First NameLast Name
Phone Number

Area CodePhone Number
E-mail
Financial Information
Bank Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Bank Officer*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Fax Number*

Fax Number
Business References
Reference 1*

Business Name

Address

CityState

Zip Code
Phone Number*

Phone Number
Fax Number*

Fax Number
Reference 2*

Business Name

Address

CityState

Zip Code
Phone Number*

Phone Number
Fax Number*

Fax Number
Reference 3*

Business Name

Address

CityState

Zip Code
Phone Number*

Phone Number
Fax Number*

Fax Number
Do you require a purchase order?*

YesNo
Persons Authorized to Charge to the Account
Please list first and last names
Must authorized users show ID at every purchase? *

YesNo
All statements will be emailed to the the Accounts Payable email address above. Would you like an invoice emailed after every charge?

YesNo
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.
Should be Empty:

Whitmore Business Application

Applicant Information

Your Company Information

Accounts Payable Information

Owner Information

Financial Information

Business References