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| Phone # (616) 534-0636 Fax # (616) 534-7851 Email customerservice@economyop.com |
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New
Account Credit Application |
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| Welcome to Economy Office Plus! If you are interested in setting up an online ordering account with us, please fill out this form and fax it back to us. A customer service representative will contact you about your application once it has been received. Thank You! | |
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Company: |
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| Company Address: |
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| City / State / Zip : |
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Telephone: |
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| Fax: |
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Shipping Address: (if different than above) |
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Name of Business Owner(s): |
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Name of Accounts Payable Contact: |
Telephone: |
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Name of Buyer: |
Telephone: |
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Are products purchased for resale or tax exempt?: |
Resale or Tax Exempt Number: |
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| Type of Business: |
Years in Business: |
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Trade References |
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| Name | Account Number(s) | Telephone | |
| Bank References |
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| Bank Name & Address | Account Number(s) | Contact Name & Telephone | |
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| Terms of Sale and Agreement Applicant will inform Economy Office Plus (in writing) of any change in company name, address or phone number as soon as such changes occur. The information given is warranted to be true and Applicant authorizes the release of all pertinent information necessary for processing the applicant’s request for credit including bank records and other financial data. Please, Only authorized signature can be accepted (CEO, VP Level Executive, Controller or Owner) |
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Print Name: |
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Title: |
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Signature: |
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Date: |
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