head-products
Credit Application
Legal Name (*)
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Address (*)
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Postal Code (*)

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Fax # (*)

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Date Commenced (*)

Invalid Input 		Date Business Incorporated (*)

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Federal Identification Number (*)

Invalid Input 		PST Exempt # (*)

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GST Registration #

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Principles of the Company
Name 1 (*)

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Name 2 (*)

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Type of Business (*)

Invalid Input 		Nature of Business (*)

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Bank Name and Address (*)

Invalid Input 		Account # (*)

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Bank Phone # (*)

Invalid Input 		Bank Fax # (*)

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Special invoicing instructions
# of INV. req'd (*)

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Statment Req'd (*)

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References
Company Name (*)

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Address (*)

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Phone # (*)

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Company Name (*)

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Contact (*)

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Phone # (*)

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Company Name (*)

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Contact (*)

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Phone # (*)

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Credit Agreement

We hereby jointly and severally agree to pay your account (if opened) according to your terms (net 30 days) and to pay interest at a rate of 2% per month (24% per annum) on all amounts in arrears as outlined in your terms and conditions of sale.

We are aware that we must obtain your permission prior to returning goods for credit and that returns are subject to a minimum restocking charge of 15% if filled as ordered.

We hereby authorize Wastequip Cusco or its agents to conduct an investigation as deemed necessary in our application for credit. Wastequip Cusco reserves the right to accept or cancel this agreement at its discretion.

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