Saunders Electric, Inc. - Seminars

Credit Application

Please fill out the following information and then press the SUBMIT button.

Firm Name			Date of Application
Your Name

Phone Number

Fax Number

Cell Number

Street Address 1

Street Address 2

City

State

Zip

Has this company been set up exclusively for one production?

Approx.

Finish Date

If subsidiary or Division, name of Parent Company

Other affiliated companies

Federal ID#

Resale Number

Year business established

At present location since

Who is authorized to order?

Are PO#’s required?

Insurance Company

Insurance Company Contact

Phone Number

Are you a:

Corporation
Partnership
LLC
Sole proprietorship

Please provide Name, Address, Phone Numbers and Title of Officers, Partners, Proprietors

1.)

Name

Address

Title

Phone Number

2.)

Name

Address

Title

Phone Number

3.)

Name

Address

Title

Phone Number

4.)

Name

Address

Title

Phone Number

Partners/Sole Proprietors please include:

1.)

Name

SSN

DL#

2.)

Name

SSN

DL#

3.)

Name

SSN

DL#

4.)

Name

SSN

DL#

Describe type of buisness:

Type description here...

Trade References:
Please furnish Name, Account Number and Phone/Fax numbers for 3 references from whom you purchase regularly on open account.

1.)

Name

Account Number

Phone Number

Fax Number

Other Number

2.)

Name

Account Number

Phone Number

Fax Number

Other Number

3.)

Name

Account Number

Phone Number

Fax Number

Other Number

Bank Information:

1.)

Bank Name

Phone Number

Fax Number

Acct#

Branch Address

2.)

Bank Name

Phone Number

Fax Number

Acct#

Branch Address

This firm certifies that the above statements are correct. Further that the firm agrees and accepts the conditions of this agreement with Saunders Electric Inc. in the event it becomes necessary for SEI to incur collection costs or institute suit to collect under this agreement or any portion thereof, the undersigned promises to pay such additional collections costs;, interests, and such sum as the court may adjure reasonable as attorney’s fees.

AUTHORIZATION TO RELEASE INFORMATION:
You are hereby authorized to request all necessary credit information from the references given on the above credit application and agreement for the sole purpose of assisting in your extension of credit to the undersigned. The said persons, bank, and/or companies are hereby authrorzed and direted to release such information to you upon request. In the event that you receive a photocopy of this authorization, it should be treated as an original and the requested information should be released.

COMPANY

AUTHORIZORS NAME

Date

Saunders Electric, Inc. Web Site © 2002.
9330 Laurel Canyon Blvd. Arleta, CA 91331
Toll Free: (888) 870-5935 Ph: (818) 771-0021 Fax: (818) 771-0107
E-mail Webmaster | E-mail Saunders Electric, Inc.