Please fax completed form to 281.599.0288
Please be sure that an officer of your company signs this application.
Fill out, print, sign and fax. Best if printed from IE. Word version: here.
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ARC CREDIT APPLICATION - DESTIN, FL Please fax completed form to 281.599.0288 Please be sure that an officer of your company signs this application. Fill out, print, sign and fax. Best if printed from IE. Word version: here. |
Name
of Company:
In Business Since:
Billing Address: City: State: Zip: Physical Address: City: State: Zip: Phone: Fax: Fed ID: |
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Type
of Customer:
Advertisers/Mkt/Graphics Architect Attorneys Automotive Engineer Financial General Contractor Government Govt Contractor Hospitals Home Builders Manufacturer Oil/Chemical Property/Real Estate Retail Schools Sub Contractor Utilities Wholesale Corporate Non-profit Org Other: |
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Contact
Name:
Email:
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If
Incorporated, Name and Title of Officers:
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If
Branch or Division,
Home Office Address:
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Home
Office Phone:
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| Branch Location: | ||
| Estimated Monthly Purchases: Credit Limit Requested: | ||
Trade
References (Do not list utilities, security service, delivery
service or credit card accounts as references) ("*" indicates required fields) |
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Company
Name* |
Fax
Number* |
Phone
Number (optional) |
Account
Number* |
| Tax
Exempt?
Yes
No If yes, exempt certificate (not a permit) must accompany this appication Are Purchase Orders Required? Yes No |
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| The information above is given to obtain an open account with ARC. ARC is authorized to make any credit inquiries necessary for approval according to the Federal Fair Credit Reporting Act U.S. Law 91-508(15USC1681). I understand that the credit terms are NET 30. The company also agrees to pay a delinquent charge of 1.5% per month for any open invoice amounts that are past our credit terms. I certify that the above information is correct and that I have the authority to incur liabilities in the name of the company. Please sign and fax completed form to 281.599.0288. |
| Authorizing Signature (officer of the co.): Print/Type Name: |
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