Springfield Blue Print and Photo Copy, Co., Inc.

General Contact Information > Credit Application

If you should need to contact us, all of the below representatives are available by phone. Our general information is as follows:


PLEASE FILL OUT COMPLETELY AND SIGN TO ESTABLISH NET 30 DAY TERMS
Desired Credit Limit
COMPANY NAME:
d/b/a:
Bill to Address
Street Address
City/State
Owners(s)/President
Accts. Payable Contact
AP Phone & Fax #
AP E-mail Address
Banking Institution
Acct. Numbers
Contact
Phone & Fax #’s
Years in Business
Dunn & Bradstreet #
Annual Sales
Net Worth
Number of Employees
Federal Tax ID #
Please attach reseller' certificate
Company Structure	Sole Proprietorship Corporation State Partnership LLC
T R A D E R E F E R E N C E S
NAME OF COMPANY:
CONTACT:
CITY STATE
PHONE:

NAME OF COMPANY:
CONTACT:
CITY STATE
PHONE:

NAME OF COMPANY:
CONTACT:
CITY STATE
PHONE:
I authorize the release of the above information to Springfield Blue Print & Photo Copy Co. for credit purposes only. In order for Springfield Blue Print & Photo Copy Co. to grant me credit, I give permission for my credit to be checked as required for that purpose. Credit terms are net thirty (30) days from the date of invoice. Interest will be charged at 1.5% per month on items over thirty (30) days. If my account is referred for collection, I agree to pay all billing and collection costs and a reasonable attorney’s fee. All the above is true and terms are accepted.
Print Officer’s Name
Officer’s Signature
Officer’s Title
Date	Monday, February 06, 2012