W H O L E S A L E C R E D I T A P P R O VA L F O R M
COMPANY PROFILEClient Name Representative
Business Name DBA
Street Address Business Type: Corp. Proprietorship Partnership
City State State of Incorporation
Phone Fax Zip Tax ID - EIN Number:
STORE OWNERSHIPName Address
Phone City
Social Security: State Zip
BANK REFERENCEName of Bank
Phone
Street Address
City State Zip
TRADE REFERENCESCompany Address
Contact Phone City State ZipCompany Address
Contact Phone City State Zip
CREDIT CARD AUTHORIZATIONCard Type Visa Mastercard American Express Discover OtherCard Number Expiration Date:
Name on Card
Billing Address City State Zip
The undersigned authorizes the above banks to release credit information to Capael Studios - SCS LLC.Signature Account No.: Date
To qualify for Net 15 or Net 30 credit terms, please fill out this form and email it to [email protected] ]. If you have any additional questions or information, please do not hesitate to call our studio at 208 . 267 . 2187. Thank you for your business and support.
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