Seastrom Manufacturing

Credit Application

* required fields

General
Shipping
Billing
Owners
Personnel
Bank References
Trade References
Final

General Information

Company Name* Division Website* Legal structure of business

Proprietorship

Corporation

Partnership

Limited Liability Co.

Length of time in business* D&B Number* Sales Tax Resale Number Resale Number for the State of

Actual resale certificate must be faxed or attached to this document for CA, UT, ID, WI, & MI.

Shipping Address

Street Address*

City*

State/Province*

Zip Code*

Email*

Phone Number*

Fax

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Billing Address

Billing address same as shipping address

Street Address*

City*

State/Province*

Zip Code*

Phone Number*

Email*

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Owners / Officers

Name*

Title*

Phone Number*

Email*

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Accounts Payable Personnel

Please list your accounts payable personnel who will manage this account

Name*

Title*

Phone Number*

Email*

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Bank References

Name

Account Number

Contact Name

Phone Number

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Trade References

Please list your trade references or attach trade reference documents when on the Final tab

Name

Account Number

Contact Name

Phone Number

Fax

Name

Account Number

Contact Name

Phone Number

Fax

Name

Account Number

Contact Name

Phone Number

Fax

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Almost there

Attach additional documents

Attach actual resale certificate for CA, UT, ID, WI, & MI.

We hereby authorize Seastrom Manufacturing Co., Inc. to contact the references provided as a part of this application along with all others provided at future dates. We authorize you to request and update credit reports, trade reports, industry reports, trade references, etc. at any time that we have an account with you.

I have read and agree to Seastrom Manufactuirng Terms and Conditions

Name* Email* Phone Number* Title* Date* Back