Credit Application

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Client Information

Customer Name*:

Address*:

City*:

State*:

Zip*:

County:

Phone*: (including area code)

Fax: (including area code)

E-Mail*:

Are you listed in D&B?:
Yes No

How long has the company
been in business?*:

Are P.O.#'s required?*:
Yes No

Owner/President's Name*:

*In order to establish an open account for your company, we need the following:
(1) Bank Reference and (3) Trade References.

Bank Reference:

Company Name*:

Phone*:

Fax*:

Contact Person*:

Address*:

City*:

State*:

Zip*:

Trade Reference #1:

Company Name*:

Phone*:

Fax*:

Contact Person*:

Address*:

City*:

State*:

Zip*:

Trade Reference #2:

Company Name*:

Phone*:

Fax*:

Contact Person*:

Address*:

City*:

State*:

Zip*:

Trade Reference #3:

Company Name*:

Phone*:

Fax*:

Contact Person*:

Address*:

City*:

State*:

Zip*:

I/We understand and agree that any credit granted shall be paid promptly in accordance with terms and agreements, that the credit grantor may add one and one half percent (1 - 1 1/2%) per month to any balance owed, and in event of default to pay reasonable collection charges and/or attorney fees.

Items marked with * are required.

Cincinnati: 513-821-3255 | 93 Caldwell Drive | Cincinnati, Ohio 45216

© 2009 Advance Building Products, Inc. | Built by Atlas Design & Technology, Ltd.