Monday February 06, 2012  
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Credit Application


If you wish to download the New Store Application, please download either the English or French PDF files and fax back to +1-800-265-5864

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TAI LUNG GROUP

NEW ACCOUNT Application
Business Contact Information
 
Title :
               
                 
Store Name :                
                   
Phone :
    Fax :     Email :
Date business commenced:
Sole proprietorship :
Y  
  Partnership :
Y   N
  Corporation :
  Y   N
  Other:
 
Business and Credit Information
Shipping address: (if different from above)
City :
    Province :  
Postal Code :
                 
Phone :
   
Fax :
 
Email :
                 
How long at current address?              
                 
 
Bank Information
Bank Name :
             
                 
Branch :
   
Phone :
  Account Number :
                 
Type of account :  
           
 
Terms requested :       Mastercard   Net 30  
Name on card :      
         
Card Number. :   Expiry Date :
If trade references are slow to respond, will you accept VISA terms on the first order?
  Y   N
 
Business/Trade References
Company Name & Contact:
         
Address :
         
City :
Province :
 
Postal Code :
Phone :
Fax :
 
Email :
Company Name & Contact:
         
Address :
         
City :
Province :
 
Postal Code :
Phone :
Fax :
 
Email :
Company Name & Contact:
         
Address :
         
City :
Province :
 
Postal Code :
Phone :
Fax :
 
Email :
Agreement
  1. I confirm that the information given above is factual and correct.
  2. By submitting this application, you authorize Tai Lung Group to make inquiries into the banking and business/trade references that you have supplied.
  3. Tai Lung reserves the right to modify the payment terms at any time based on your credit history.
FOR OFFICE USE ONLY
 Credit Limit:  Rating:  Approved By:  Date:
 

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