Credit Information Form

Your order will be held until this form is returned with all the information provided. If your order cannot be shipped on open account, you will then be notified

Download PDF version of this form here

* Required

Name of Business *

Address 1 *

Address 2

City *

State *

Zip *

Type of Organization *

Corporation

Partnership

Individual

No. Years in Business *

No. Years in this Location *

Contact Name *

Contact Phone *

Contact Position

Name of Your Bank *

Bank Address 1 *

Bank Address 2

Bank City *

Bank State *

Bank Zip *

Bank Acct. # *

Bank Contact *

Three Credit References from Whom You Purchase: Name, Address & Phone #

1. *

2. *

3. *

Are You Paying Your Bills Within Terms?

Yes

Estimate of Annual Sales Volume *

Estimate of Business Asset Value *

What Dollar Amount of Credit Does Your Company Require? *

I certify that the above information is true and correct. I agree that in return for the privelege of buying on open account, if I do not pay within terms, I will pay 1-1/2% per month financing charges (18% per annum) on past due invoices and any collection cost that may arise.

General Films agrees to keep this information strictly confidential