Office Supplies Credit Application Account Desired (Check One) C.O.D.:                                                                       (Complete Section 1)                       Credit Card: (Complete Section 1)                          *Open Account: (Complete All Sections) *Terms are as follows for open accounts: All invoices are net 30 days from date of purchase.  Any balance over the invoice term will accrue compounded interest of 1.5% per month.  Accounts over 60 days past due will become C.O.D. until the balance is cleared. Section 1 Applicant Name:   Billing Address:        Applicant City:  Applicant State:          Applicant ZipCode: Applicant Phone: Applicant Fax: E-mail Address: Shipping Information Ship To Address: Ship To City: Ship To State: Ship To ZipCode: Tax Information Type of Business: Federal ID #: Tax Exempt #: Name of Authorized Agent: Agent Title: Agree To All Terms (Required): Section 2 Primary Business Owner: Primary Owner Title: Business Owner: Owner Title: Bank Information Bank Phone: Contact: Bank Address: Bank City: Bank State: Bank ZipCode: Trade & Reference Information Reference 1 Name: Reference 1 Phone: Reference 1 Fax: Reference 1 Address: Reference 1 City: Reference 1 State: Reference 1 ZipCode: Reference 2 Name: Reference 2 Phone: Reference 2 Fax: Reference 2 Address: Reference 2 City: Reference 2 State: Reference 2 State: Reference 2 ZipCode: Reference 3 Name: Reference 3 Phone: Reference 3 Fax: Reference 3 Address: Reference 3 City: Reference 3 State: Reference 3 ZipCode: Comments/Questions/Instructions: Reset Form: