Company Legal Name
DBA
Billing Address
City
State
ZIP Code
Shipping Address
AP Contact
AP Phone
AP Email
Email to send invoices
Type of Business (Exporter, Distributor, Manufacturer of..., etc.)
Number of Employees
State of Incorporation
Federal Tax ID #
Annual Sales
Credit Limit Request
Website
Name
Title
Company Name
Contact Name
Email, Fax, or Phone
Bank Name
Phone #
Fax #
Account Type
Account Number
Applicant authorizes Master Electronics to obtain credit and financial information for the purpose of establishing an open line of credit. The information above is true and correct to the best of my knowledge and belief.
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