Credit Application - KNS Industrial Supply

[wpdm_package id=’21587′]

Company Name * Required
DBA * Required
Contact Name * Required
First Last
Contact Title * Required
Email * Required
Phone * Required
Address * Required
Street Address City State / Province / Region ZIP / Postal Code Country
Type of Business * Required
- Corporation
- LLC
- Partnership
- Single Proprietorship
- Other
Fax
Bank References
Bank Name * Required
Phone * Required
Fax
Bank Contact Name * Required
Bank Contact Title * Required
Email
Bank Address * Required
Street Address City State / Province / Region ZIP / Postal Code Country
Vendor References
Vendor #1
Vendor Name #1 * Required
Type of Business * Required
Phone * Required
Account# * Required
Contact Name * Required
Fax
Vendor #2
Vendor Name #2 * Required
Type of Business * Required
Phone * Required
Account# * Required
Contact Name * Required
Fax
Vendor #3
Vendor Name #3 * Required
Type of Business * Required
Phone * Required
Account# * Required
Contact Name * Required
Fax
* Required
- All information contained in this credit application is true and accurate and is furnished to KNS Industrial Supply in order to induce KNS Industrial Supply to grant credit to customer. Customer authorizes KNS Industrial Supply to obtain credit and financial information concerning Customer at any time and from any source and agrees to hold harmless KNS Industrial Supply against any claim for doing so.
Applicant Name * Required
Applicant Title * Required
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Bank References