6630 N. 47th Ave Suite # 1
Glendale, AZ 85301
Tel: (623) 934-0973 / Fax: (623) 934-0808
www.BestBP.com / david@bestbp.com
BUSINESS CREDIT APPLICATION
Type of Business: □ Company
□ Corporation Partnership
□ Partnership
Name of Business: ___________________________________________________
Business License Number: _____________________________________________
Business Address: ____________________________________________________
Business Telephone: ________________________ Fax: ______________________
How long at this address? ____ Date business opened _________ Type of business _____________
Full Name of Owner or President: ______________________________________________________
Sales Tax Status: □ Taxable □ Non-taxable
(If non-taxable, a signed tax exemption certificate must be attached)
Name of person to contact regarding payment: ____________________________________________
BANK REFERENCE
Name of Bank: _____________________________ Contact: _____________________________
Address: _____________________________ Phone: _____________ Account No. ______________
CREDIT TRADE REFERENCES (TWO REQUIRED)
Name
Address
Phone
Account No.
Amount of credit requested: ___________________________________
TERMS: Net 10th prox interest charged at 1.5% per month (18% per annum) will be added to accounts over 30
days past due.
COPYRIGHT LICENSE INDEMNIFICATION AGREEMENT: I represent that I am familiar with the copyright laws
governing reproduction of copyrighted materials. I warrant that I have received permission and license from the
copyright owner of the film, print, slide, movie, artwork, digital medium or other material (hereafter referred to as the
“photos”) submitted for processing and/or printing to reproduce the photos for the purposes that I intend to use
them. I have the legal right to, and do authorize and grant a non-exclusive license to Glendale Blueprint and its
agents to reproduce the photos and return them to me or my agents.
I understand that the information furnished on this application is for the purpose of obtaining business credit. To the
best of my knowledge, the information given is true and correct. Further, I have read the Terms and Copyright
License Indemnification Agreement and agree to them as stated.
Name and Signature: _________________________________________ Date: _________________