Mountain Credit Application

Mountain Commercial Graphics BUSINESS CREDIT APPLICATION CUSTOMER SERVICE Toll Free 50 States & Canada 1-800-950-4923 FAX 1-800-967-3986 Local FAX 1-713-895-1360 Local Phone 1-713-895-1350 Thank you for expressing an interesting in obtaining an open account with Mountain Commercial Graphics. Please fill out the Credit Application below completely. The more information we have, the easier it is to make credit judgements. Company / Organization Information * - Indicated Input is Required! Fed Tax ID or SSN:* Full Company Name:* Street Address:* Billing Address:* Individual Partnership Corporation State:* City:* State:* Zip:* Shipping Address:* State:* Zip:* Phone:* FAX:* Nature of Business: No. Employee: Years at This Location: Years in Business: Is Your Company a: Name of Parent Company: BranchSubsidiary Company / Organization Officers Data   Name of Owners or Officers: Position: 1) 2) 3) Payment / Billing Data Do you desire to place orders via a Purchase Order: YesNo + If you select "Yes" above, the information under the "Person To Contact For Purchase Orders" will be required to process your request. If you select "No" the information under the "Person To Contact For Payments" will be required to process your request.   Person To Contact For Payments   Person To Contact For Purchase Orders Name Name Phone Phone Title Title Email Email Business References Duns No.: Name Address including Zip Acct. # Fax * * * * * * * * * * * * Banking References   Name * Address * Person to Contact * Checking Acct. # * Saving Acct. # * Phone * Tax Exempt: YesNo   Taxable: YesNo Tax Cert. #: * State: * Amount of Credit Desired in Any 30 Day Period: * (Please input with no spaces or no commas, Ex. 20000) Additional Information: TERMS AND CONDITIONS: Payment for all purchases are due on the 30th calendar day following shipment of that order. Should the credit of Buyer in the judgement of the Seller, become impaired at any time, the Seller has the right to require payment in advance before making further shipments, and to demand immediate performance of the Buyer of all obligations imposed upon him by this agreement. TO INDUCE YOU TO ACCEPT OUR CREDIT FOR PURCHASES UNDER YOUR CREDIT SALE TERMS, WE AUTHORIZE YOU TO CONTACT THE REFERENCES GIVEN ABOVE (INCLUDING OUR BANK) TO OBTAIN SUFFICIENT AND SATISFACTORY CREDIT INFORMATION. I HAVE READ AND ACCEPT THE TERMS AS STATED ABOVE: The Above Check Box must be Checked or the Application will not be processed. Submitted By: * Title: * Email: * Date: *

For additional information or questions, please write us at info@mountain-cg.com.