Credit application

We must have received your credit application prior to releasing your first order.

Name of firm/farm :             

Business/farm address : # Street City Province/State Zip Code
Send invoice to :    Same :   Other : 

Business/farm adress :   

#

Street

City

Province/State

Zip Code

  

Important Notice

    Stores, resellers, distributors
    • You must send by fax ( 1 - 418 - 834 - 1823 ), mail or email your resale tax certificate.
    Farms
    • You must send by fax ( 1 - 418 - 834 - 1823 ), mail or email your Agriculture sales tax exemption.

IRS number or Social Security number ( for custom purposes ) :

Phone # ( complete ) :

Fax # ( complete ) :

Name of owners

1)

Title :

Since :

2)

Title :

Since :

3)

Title :

Since :

Type of business
Account payable supervisor :
Phone # ( complete ) :
Year founded :

Bank's name
Contact :
Phone # ( complete ) :
Fax # ( complete ) :

Credit references

Name of company

Contact

Phone number

Fax number

1)

2)

3)

4)



Date :
Name :
Title :
Email :