Investments Hardware Ltd.
127B Aviva Park Dr., Woodbridge, ON L4L 9C1
TEL. 416-748-0204 | FAX. 905-851-8328
www.IHLCANADA.com
CLIENT CREDIT APPLICATION & AGREEMENT FORM
Legal Name of Business:
o Corporation
o Partnership
o Proprietorship
PO REQUIRED? YES o NO o
Business Address:
Business Phone:
(
)
# of locations or branches:
Date registered or incorporated:
City/Town
Fax Number:
(
)
# of employees:
Province/State
Bank:
Account and Transit Number (Mandatory):
Postal Code:
How Long:
E-mail:
Web Site:
Nature of Business:
Annual Sales:
Name of Principal Shareholder / Owner of Business:
Accounts Payable Contact:
Amount of Credit Requested:
Trade Name (If different):
Name of President if Incorporated:
Telephone Number:
Ext:
Fax Number:
Email:
BANK REFERENCES
Full Address:
Account Manager:
Telephone Number:
TRADE REFERENCES
How long?:
Name & Address:
Name & Address:
Name & Address:
Name of Contact:
Name of Contact:
Name of Contact:
Telephone Number:
(
)
Name & Address:
Telephone Number:
(
)
Name & Address:
Telephone Number:
(
)
Name & Address:
Name of Contact:
Name of Contact:
Name of Contact:
Telephone Number:
(
)
Telephone Number:
(
)
Telephone Number:
(
)
Name
$
PERSONAL DATA ON PRINCIPAL/OWNER OF BUSINESS
Residential Address
Position
Signature
Please fill out the form completely and fax it back to: 905-264-2965 Attention: Credit Department
PLEASE PRINT CLEARLY
IMPORTANT: Incomplete information will delay processing of your credit application.
By signing below, I authorize Investments Hardware Ltd. and or its agents, Lumbermen’s/Mercantile Credit Bureau, to contact any references given at any time in relation to credit granted, including banks; to release
and exchange such credit, banking and financial information as may be necessary to determine credit standing. I also grant permission to the trade and bank references listed above to impart financial information
requested by Investments Hardware Ltd. or their agents, Lumbermen’s/Mercantile Credit Bureau, in the course of regular credit investigations. As the Principal/Owner/Operator referred to herein, I take notice that
reports will be sought containing personal information, financial information and credit information and I consent to the receipt, disclosure and exchange of such information to other business related parties, agents
and consumer reporting agencies. As the undersigned I hereby agree that subsequent credit information may be obtained throughout the duration of the business relationship and consent to the release of said
information. The undersigned agrees to notify Investments Hardware Ltd. in writing of any changes in ownership, company name or manner in which the business operates and that a new credit application may be
requested at any time during the course of the business relationship. I certify that the above information is true and correct. I also certify that I am authorized to bind the company and agree to pay inv oices in full
within 30 days from date of invoice.
AGREEMENT
I HAVE READ AND UNDERSTAND THE TERMS & CONDITIONS. I ALSO UNDERSTAND THAT INVESTMENTS HARDWARE LTD. CAN CHANGE ITS POLICY AND CAN CANCEL CREDIT SUPPORT SERVICE AT ANY TIME.
Authorized Signature for Applicant:
Title/Position:
Print Name of Person who signed this application:
Telephone:
Date Signed: