Credit Application (Confidential)

If you prefer, you can download a PDF version of the Confidential Credit Application, print out, complete, and FAX back to (732) 345-7445.

Customer Information
Date:

Legal Business Name: (As it appears on Business License)
DBA or Trade Style (if applicable):
Business Address 1:
Business Address 2:
City:
State:
Zip:
Country:

Phone:
FAX:

State of Incorporation / Organization (Required):
Federal Tax I.D. #:
Dun & Bradstreet #:

President, Partner, Owner:
Phone and/or E-mail Address:

Vice President, CFO, Controller:
Phone and/or E-mail Address:

Accounts Payable Manager:
Phone and/or E-mail Address:

Buyer:
Phone and/or E-mail Address:

Terms Requested:	Cash In Advance Terms
Net Terms Requested:	Days
Credit Line Requested:

FOR PROPRIETORSHIPS, PARTNERSHIPS & SMALL CORPORATIONS PERSONAL CREDIT MAY BE CONSIDERED
Officer's Name:
Social Security Number:
Street Address:
City:
State:
Zip:

Officer Grants Use of Personal Credit:	Accept Decline
Date:

Ship To
Address 1
Street Address:
City:
State:
Zip:
Country:

Address 2
Street Address:
City:
State:
Zip:
Country:

Trade References
Trade & Bank References, Fax #'s are mandatory
Check if faxing References Separately Trade & Bank References:	Faxing Document(s) Use Number 732-345-7455.

Reference 1:
Company Name:
Address:
City:
State:
Zip:
Country:
Credit & Collections Contact Person:
Phone:
FAX:

Reference 2:
Company Name:
Address:
City:
State:
Zip:
Country:
Credit & Collections Contact Person:
Phone:
FAX:

Bank References
Reference 1:
Bank Name:
Account #:
Address 1:
Address 2:
City:
State:
Zip:
Contact:
Phone:
FAX:

Reference 2:
Bank Name:
Account #:
Address 1:
Address 2:
City:
State:
Zip:
Contact:
Phone:
FAX:
Acceptance and Approval:
Checking this box acts as your digital signature and indicates your acceptance of the Main Steel Polishing Company, Inc. Limited Warranty and Terms and Conditions as stated. In addition you authorize Main Steel Polishing to make any and all inquiries necessary to process this credit application.

Your Perfect Supply Chain

Credit Application (Confidential)

Acceptance and Approval: