Commercial Credit Application for Waste & Recycling

Business Contact Information
Company Name*
Email*
Phone*
Fax Number
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Business Owner
Business Owners(s)*
Business Owner(s): Other
Person Responsible for Payment*
Federal ID or Social Security*
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Billing Information
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Fax Number
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Bank Information
Bank Name*
Bank Phone*
Bank Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of Account*
Type of Account: Other
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Business Reference 1
Company Name*
Email*
Phone*
Fax Number
Type of Account*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Business Reference 2
Company Name*
Email*
Phone*
Fax Number
Type of Account*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Business Reference 3
Company Name*
Email*
Phone*
Fax Number
Type of Account*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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Agreement
1. All invoices are to be paid 10 days from the date of statement. If payment in full is not received within 30 days of statement date, a finance charge of 1 1/2 % per month shall be imposed upon the unpaid balance of your account for the previous month and credit privileges will be terminated.
2. Claim arising from invoices must be made within seven working days.
3. By submitting this application, you authorize EJE or EJE'S commissioed ajent to make inquires into the back and business/trade references that you have supplied
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Business Contact Information