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KAMAZU CREDIT APPLICATION

Customer Name : *
Business Name : *
Address : *
Unit / Suite # :
City : *
Province/State : *
Zip Code/Postal Code : *
Phone : *
Fax :
Email : * ( This will be considered as your login Email )
Sales Person Name :
Year Established :     Business Type:
Sole Owner    Partnership    Corp.
Principal Officers, Owners or Partners :
Name : Position  : 
Name : Position  : 
Name : Position  : 
Bank Address :    
Telephone # : Bank Account Name:
Credit References #1
Company : Contact  : 
Address :
Telephone # : Fax  : 
Credit References #2
Company : Contact  : 
Address :
Telephone # : Fax  : 

Credit References #3
Company : Contact  : 
Address :
Telephone # : Fax  : 
 
   
 
I/We make this application to Kamazu to open a credit account. I/We certify that all information given in this application is correct and complete. I/We authorize and consent to veri-fication of all information as required for the sole purpose of opening a credit account. I/We agree that if our company is approved for credit that I/We agree to the terms and conditions of account payments including all credit service charges on overdue account balances as detailed in the packing slips, price and terms and conditions of sale which may vary from time to time.