20321 Lake Forest Drive, Suite D2  Lake Forest, CA  92630  Tel: (949) 305-6530 Fax: (949) 305-6477 info@approvedmemory.com

 

 

CREDIT APPLICATION
Please complete form, print, and fax, e-mail or mail as noted above.

 

 

Company Information

 

Company Name/DBA:

     

Address:

     

City:

     

State:

     

Zip:

     

Phone:

     

Fax:

     

E-mail:

     

 

                         Corporation                         Partnership                         Individual Owner

 

 

Name of Officers, Partners, And/Or Owners

 

Name:

     

Title:

     

Phone:

     

Name:

     

Title:

     

Phone:

     

 

Address:

     

City, Sate, Zip:

     

Federal ID No.:

     

 

Resale No/SS#:

     

Number of Employees:

     

 

Number of Years in Business:

     

Approximate Annual Sales:

     

 

 

Bank Information

 

Bank:

     

Account #:

     

 

Address:

     

 

City:

     

State:

     

Zip:

     

 

Contact:

     

Phone:

     

Fax:

     

 


APPROVED MEMORY, CORP.


20321 Lake Forest Drive, Suite D2  Lake Forest, CA  92630  Tel: (949) 305-6530 Fax: (949) 305-6477 info@approvedmemory.com

 

 

CREDIT APPLICATION
(Continued)

 

trade references (please list at least 3)

 

Company:

     

Account #:

     

 

Address:

     

 

City:

     

State:

     

Zip:

     

 

Contact:

     

Phone:

     

Fax:

     

 

Company:

     

Account #:

     

 

Address:

     

 

City:

     

State:

     

Zip:

     

 

Contact:

     

Phone:

     

Fax:

     

 

Company:

     

Account #:

     

 

Address:

     

 

City:

     

State:

     

Zip:

     

 

Contact:

     

Phone:

     

Fax:

     

 

 

 

please attach a copy of the following:

 

            Resale Certificate

 

            Proof of freight insurance

 

            Signed Authorization to Release Information Sheet (included)

 

        Dun & Bradstreet # (if applicable)

 

        Copy of “void” check

 

** Please make sure your Bank and Trade phone numbers are current.

APPROVED MEMORY, CORP.


20321 Lake Forest Drive, Suite D2  Lake Forest, CA  92630  Tel: (949) 305-6530 Fax: (949) 305-6477 info@approvedmemory.com

 

 

CREDIT APPLICATION

(Continued)

 

Authorization to Release Information

 

The customer agrees that Approved Memory, Corp. may contact the references provided, herein, for the purpose of obtaining a current credit rating.

 

The information provided is true and complete.  The customer understands that the foregoing information is material and will be relied upon in determining whether to extend credit or supply parts.

 

 

Company:

     



     

Authorized Signature

     

Please Print Full Name

     

Title

     

Date