Service and Support



   
 
   
   

Credit Application Submission
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Your Name:
Your Email:

 Account Information:
Account Name:
Bill To Address:
City: State:
Zip Code:

Ship To Address:
City: State:
Zip Code:
Type of Business:
EIN/Social Security Number:

 Relevant Contacts:
 Type of Purchase Control System:
Purchase Order Only Phone Contracts If Other, please specify:

Owner/General Manager:  
Name:
Phone:
Mobile:
Fax:
E-Mail:
Purchasing Contact:  
Name:
Phone:
Mobile:
Fax:
E-Mail:
Finance/Accounts Payable:  
Name:
Phone:
Mobile:
Fax:
E-Mail:

Credit Line Requested: $    

 Bank Reference:
Bank Name:
Address:
City: State: Zip:    
Phone: Fax:
Contact Name: Mobile:
E-Mail:    
Please check all that apply:
Checking:
Savings:
Term Debt:
Line of Credit:

 Trade References (please list 3):
Name:
Address:
City: State:
Zip Code:
Phone:   Fax:
E-Mail:

Name:
Address:
City: State:
Zip Code:
Phone:   Fax:
E-Mail:

Name:
Address:
City: State:
Zip Code:
Phone:   Fax:
Email:
   
 Sales Tax:
Taxable:   If not taxable, please attach a copy of your tax exempt certificate.

We declare the above information is correct and complete and is given to induce Whiting Door Manufacturing Corp (“Company”) to extend credit. We authorize the Company to make such credit investigation as the Company sees, including contacting the above trade references and banks and obtaining credit reports. We authorize all trade references, banks, and credit reporting authorities to disclose to the Company any and all information concerning the financial and credit history of my company and myself. I understand that all invoices are payable in 30 days unless noted otherwise. I agree to pay finance charges up to my state’s legal limit for any amounts not paid within the agreed upon terms. I have read the terms and conditions and agree as indicated by clicking submit.

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