14928 Oxnard StreetVan Nuys, CA 91411-2610
(818) 904-A524 (800) 826-5432Fax (818) 781-6847
E-mail [email protected]. allelectron ics.com
CREDIT APPLICATIONIn order for All Electronics Corporation to process your credit application quickly and efficiently, it isimportant to fill out the application completely. Additional comments about your company arewelcome. P/ease complete both pages and the Bank Authorization form.
Customer # (if ordered before)
Business Name
R A T I O N
Electronics Parts And Supplies
Bill ing Address
Phone
City State zipE-Mail
Shipping Address (if different than above)
City State _ZipAre you a branch, division or subsidiary of another company? ( ) Yes ( ) No
Company Name
Address City State _Zip
THIS INFORMATION MUST BE COMPLETED IN ORDER FOR YOUR APPLICATION TOBE CONSIDERED.
_Corporation _Manufacturer _Retailer _Partnership _Distributor _Technical School
_Proprietorship _Wholesaler _OtherProducts manufactured or distributed
Date established or incorporated
Tax Exempt _ CA Resale #
approximate annual gross sales
(CALIFORNIA-Attach a signed resale card)
Credit Amount Requested $
ts A FoRMAL HARD COpy PURCHASE ORDER REQUTRED? ( / vES ( ) NOAll Electronics Gorporation credit terms are NET 30 days, no discounts. The applicant agrees to paywithin these terms if credit is approved. All Electronics Gorporation reserves the right to close anyaccount if NET 30 terms are not met. By signing this application the applicant acknowledges that allinformation on this application is true to the best of their knowledge and agrees to our NET 30 credit
terms.
Fax
Signature (required) Title Date
2.1
City
4.3
zipCity
Trade ReferencesFull address and fax numbers will help receive the responses in the quickest manner.
(PLEASE TYPE OR PRINT CLEARLY)
Company Name Company Name
Address
State zip City State zip
Phone number Phone number
Fax number Fax number
Account number Account number
Company Name Company Name
Address Address
State City State zip
Phone number Phone number
Fax number Fax number
Account number Account number
Bank Information
Account number Type Date opened
Bank name Contact Phone number Fax number
Address City State zip
R A T I O N
Electronics Parts And Supplies
14928 Oxnard StreetVan Nuys, CA 91411-2610
(818) eO4-0524 (800) 826-5432Fax (818\ 781-6847
E-mail [email protected]
AUTHORIZATION OF RELEASE INFORMATION
Below please find a wriften authorization for release of credit information. Most banksand financial institutions will not release information without prior writtenauthorization. We can not complete your credit applications without bank information.
We hereby authorize to release any
pertinent information regarding our" "fitlt,iffi] ""uing"
and borrowing accounts
to ALL ELECTRON/CS CORP. for the purpose of establishing an open account
with said company.
Signed
Title
Date
Company
Checking account #