Name/Address

Title *

First Name *

Last Name *

Email *

Phone *

Company Name *

Address *

Tax I.D. Number

Additional Emails

Zip Code

City

State

Accounts Payable Contact

Accounts Payable Email

Taxable or Resale: (If Resale please complete attached resale certificate)

Taxable
Resale

Bank References

First Contact

Institution Name

Checking Account #

Address

Contact Person

Phone

Second Contact

Institution Name

Checking Account #

Address

Contact Person

Phone

Trade References

Your requirements

First Contact

Company Name

Address

Contact Name

Phone

Second Contact

Company Name

Address

Contact Name

Phone

Third Contact

Company Name

Address

Contact Name

Phone

Financial Information

1. All invoices are to be paid 30 days from the date of the invoice. Invoices past 30 days will be charged 1-1/2% service charge per month on all past due accounts.

2. Claims arising from invoices must be made within seven working days after receipt of items or invoice.

3. By submitting this application, you authorize Maskell Rigging & Equipment to make inquiries into the banking and business/trade references that you have supplied.

Company Total Assets

Company Total Liabilities

Amount of Credit Requested

Annual Net Income

Have you or your officers or affiliates ever filed a petition in bankruptcy?

Is your company subject to any litigation?

If yes, please describe

I have read, understand, and agree to the above terms. In the event that it becomes necessary to place this account with an attorney for collection, customer agrees to pay all collection costs including attorney’s fees.

Date Signed

Company Name

Full Name

Title

Attach Signed Copy (Must be an Officer of the Company)

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-116692-file2-1_

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Thanks for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Business Credit Application

Name/Address

Company Information

Bank References

Trade References

Financial Information

Built on Strength

Single Leg Chain Assemblies