Credit Application

Business Information
Trade Name*
Physical Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone Number*
Cell Number
Fax Number
Ownership*
- Individual
- Partnership
- Corporation
Owner or Principal*
- Owner
- Principal
Nature of Business*
Business Established*

Billing Information
Name*
First Last
Phone Number*
Fax Number
Email*
Same as physical address?
- Yes
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
GST #*
PST Exempt (If yes, please submit exemption certificate at the end of the form)*
- Yes
- No
PST #*
Purchase Orders Required?*
- Yes
- No
Credit Limit Required
Currency*
- CAD
- USD

Bank Reference
Prefer to attach (see end of form)
- Yes
Bank Name*
Name*
Phone Number*
Fax Number*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit References
Prefer to attach (see end of form)
- Yes
Company Name*
Name*
First Last
Phone Number*
Fax Number*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company Name*
Name*
First Last
Phone Number*
Fax Number*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company Name*
Name*
First Last
Phone Number*
Fax Number*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Review
As a result of it's application for a revolving line of credit (hereinafter the "credit") with CAN-AMERICAN CORRUGATING CO LTD (hereinafter the COMPANY) and in consideration of the granting of the credit to the applicant by the COMPANY, the applicant hereby agrees to the following terms and conditions. 1. The applicant shall pay in full to the COMPANY, each invoice on the 15th of the following month of the invoice date. 2. On any amounts not paid in full by the 15th of the following month, the applicant agrees to pay interest on all such outstanding amounts at the rate of 2% per month accruing as of the date of the invoice, which interest shall be added onto the next monthly statement's) issued. 3. The applicant as a company and as an individual, agrees to maintain at all times, its indebetness towards the COMPANY account within the credit limit granted. According to the terms and conditions herein, the COMPANY reserves its right from time to time without notice to either grant, increase decrease and/or revoke for what-ever reasons, the applicant. The applicant, recognizing that the granting of any form of credit by the COMPANY does not create any obligations of any sort or nature upon the COMPANY to maintain such a credit facility and waives any and all rights it may have should the COMPANY as a result of any acts and/or omission of the latter in connection with such credit suspend or revoke said credit. 4. The applicant shall, if there are any changes in its ownership, shareholders, or corporate control, inform the COMPANY immediately in writing and agrees to make a new credit application to the COMPANY. All credit granted as a result of the former credit application and agreements subscribed to as a result of same to be deemed cancelled as of the date of such changes in ownership and all amounts the owing and outstanding shall be deemed due and payable immediately, without notice or demand. 5. All goods sold to the applicant by the COMPANY shall remain the property of the COMPANY until full and final payment thereof including all interest charges and the applicant hereby cedes and transfers unto the COMPANY the proceeds of any and all resale of products sold until full and final payment has been received. 6. The applicant and where applicable, its undersigned representative, hereby declares and certifies that all statements made in and pursuant to the attached credit application are true and correct.
I agree to the Terms and Conditions*
- Yes
Signature
Name*
First Last
Company Name*
Title*
I am authorized to sign on behalf of the company*
- Yes
Date*
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

Credit Application

Step 1 of 6

Business Information

Billing Information

Bank Reference

Credit References

Attach Files

Review