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

Other
Federal ID Number
Tax Exempt
If yes

Upload a File
Upload copy of Federal Exemption Letter Cancelof
Ace Rewards Member
Member Number
Will this be for resale?
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?
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?
Persons Authorized to Charge to the Account
Please list first and last names
Must authorized users show ID at every purchase?
All statements will be emailed to the the Accounts Payable email address above. Would you like an invoice emailed after every charge?
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