Fain Office Supplies - Open Commercial Account Credit Application

Fain Enterprises COMMERCIAL OPEN ACCOUNT CREDIT APPLICATION


1.	Enter all information requested.	2.	Review the terms below.
3. Upon submission our credit representative will call you back.
* = Required Information for Open Account Review
You may download a pdf printable version here

Customer Data Information

* Full Legal Business Name:

Doing Business As or Also Known As:

* Business Contact Full Name:

Business Contact Title:

* Phone Number:

Fax Number:

Billing Address (cannot be a PO Box):

Address line 2:

City:

State:

ZIP:

* Email Address:

* Confirm Email:

Fain Enterprises Customer# (If known):

Shipping Address(if differs from billing):

Shipping City:

Shipping State:

Shipping ZIP:

Shipping Phone Number:

* Anticipated Monthly Purchase Volume $:

Does company require a purchase order?

Is the authority for purchasing limited to certain individuals within your company?

If yes, list those with purchasing authority

Cut-off time for receiving merchandise

Dock Delivery, or other special delivery requirements?

Accounts Payable Information

A/P Contact Name:

Phone Number and Ext.:

Fax Number:

Legal Structure:

Business Structure:

State of Incorporation

* Taxpayer ID Number or SSN:

Business Type/SIC (please select one)

Dun and Bradstreet Number (If available):

Company Annual Revenue:

In Business Since:

Non-Profit?:

No. of Employees:

No. of Locations:

Franchisee?:

Tax Exempt for Office Supplies?: (If yes,
copy of certificate must be submitted)

Names, Titles and addresses of your corporate officers or partners

Have you ever had open terms of payment with us before?

If yes, under what name?

Trade References

Reference #1	Name:
	Address:
	Phone #:	Fax
Reference #2	Name:
	Address:
	Phone #:	Fax
Reference #3	Name:
	Address:
	Phone #:	Fax

Bank References

Account #:			Phone:
Contact Person:
Name of Bank:
Address:

I give Fain Enterprises permission to send emails.

GENERAL TERMS AND CONDITIONS

Invoices are delivered with your merchandise (unless otherwise specified by you in writing).
All Invoices are due and payable in full within 15 days of the invoice date.
A service charge of 1.5% per month (18% per year) will be added to all amounts billed if not paid within 30 days of the invoice date.
No additional credit will be extended to past due accounts unless satisfactory arrangements are made with our credit department.

By submitting this form, I represent that the above information is true and is given to induce Fain Enterprises, Inc. to extend credit to the applicant.

I have read the terms and conditions and agree to all of these terms and conditions.

You may download a pdf printable version here