Credit Application - New Bedford Welding Supply

Thank you for expressing an interest in becoming one of our valued customers. In order to establish open credit with New Bedford Welding Supply Inc. Please fill out this credit application, sign it, & email to sales@nbweldingsupply.com or fax to 508-992-9670. A state tax certificate form MUST be returned with this application to process your orders tax exempt.

PRINT THE CREDIT APPLICATION FORM

OR COMPLETE AND SIGN THIS ONLINE APPLICATION

Ship To:
Name*
Address*
Street Address City State ZIP Code
Bill To:
Name*
Address*
Street Address City State ZIP Code
Accounts Payable Info:
Name*
Email*
Phone*
Fax
Email Invoices and Statements?*
Fax Invoices and Statements?*
Purchase Order Required?*
Name of Owner*
Address*
Street Address City State ZIP Code
*
- Sole Proprietorship
- Partnership
- Corporaton
Date Business Started*
Date Format: MM slash DD slash YYYY
Requested Credit Line
FED I.D. #
Social Security #
F/V Documentation #
Resale Cert. #
For Individual Applications (non-commercial) Only
Employer
Address
Street Address City State ZIP Code
Number of Years Employed
Contact
Phone
Fax
Email
Do You Own Your Own Home?
Cell Phone #
Trade References
Incomplete Applications Cannot Be Processed
Company
Address
Street Address City State ZIP Code
Account #
Contact
Phone
Fax
Email
Company
Address
Street Address City State ZIP Code
Account #
Contact
Phone
Fax
Email
Company
Address
Street Address City State ZIP Code
Account #
Contact
Phone
Fax
Email
Bank Info:
Bank*
Address*
Street Address City State ZIP Code
Phone*
Contact*
Account #*
*
- Checking
- Savings
The applicant guarantees that the information contained in this application is true and correct to the best of his/her information and belief, and realizes it will be relied upon in the granting of future credit. Applicant authorizes a credit inquiry and a release of credit information, including but not limited to, the obtaining of a credit report and agrees to furnish additional credit references and other pertinent information if requested. If granted credit, I/we agree to pay all invoices within 30 days of the invoice date and pay any interest on past due balances. In the event it is necessary that the account be placed with others for collection,I/We agree to pay collection costs and/or attorney's fees. It is agreed that my/our account may convert to prepay status if I/we fail to pay within stated terms. Applicant personally guarantees payment of any and all indebtedness of applicant.
Authorized Signature of Applicant*
Title*
Date*
Date Format: MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

Ship To:

Bill To:

Accounts Payable Info:

For Individual Applications (non-commercial) Only

Trade References

Bank Info:

Gases, Cylinder Repair or Equipment Repair - Call 800-662-3357

New Bedford, MA

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