Credit Application for a Business Account Business Contact InformationTitle(Required) Company name(Required) Phone | Fax(Required) E-mail(Required) Registered company address City, State ZIP Code(Required) Date business commenced (Required) Sole proprietorship Partnership Corporation Other Business and Credit InformationCity, State ZIP Code(Required) How long at current address?(Required) Phone(Required) Fax E-mail(Required) Bank name:(Required) Primary business address City, State ZIP code(Required) Phone(Required) Account number(Required) Type of account(Required) Savings Checking Other Business/Trade ReferencesReference oneCompany name(Required) Address(Required) City, State ZIP code(Required) Type of Account(Required) Phone(Required) Fax E-mail(Required) Other Reference twoCompany name(Required) Address(Required) City, State ZIP code(Required) Type of Account(Required) Phone(Required) Fax E-mail(Required) Other Reference threeCompany name(Required) Address(Required) City, State ZIP code(Required) Type of account(Required) Phone(Required) Fax E-mail(Required) Other Agreement1. All invoices are to be paid 30 days from the date of the invoice.2. Claims arising from invoices must be made within seven working days.3. By submitting this application, you authorize Marina Electrical Equipment, Inc. to make inquiries into the banking and business/trade references that you have supplied.SignaturesSignature(Required) Reset signature Signature locked. Reset to sign again Name and Title(Required) Date(Required) Second Signature if Two People are ApplyingSignature Reset signature Signature locked. Reset to sign again Name and Title Date
