Rhea Designs Inc. Credit Application

Application Type

Requested Terms:
NET 30 DAYSPrepaid

Requested Credit Line:

Applicant Details

First Name:

Last Name:

Title:

Name of Business:

Phone Number:

Business Address:

City:

State:

Zip:

Tax ID No.:

Resale Certificate No.:

Website:

DnB No.:

Company Information

Type of Business:

In Business Since:

Legal Form Under Which Business Operates:

Corporate Corporate
Partnership Partnership
Proprietorship Proprietorship

Name of Principals

Accounts Payable Contact

Name:

Email:

Bank Reference

Bank Name:

Account No.:

Address:

Contact Person:

Phone No.:

Email:

Trade References

1st Reference

Company Name:
Contact Name:
Account No.:
Phone No.:
Street Address:
City, State, Zip Code:
Email:

2nd Reference

Company Name:
Contact Name:
Account No.:
Phone No.:
Street Address:
City, State, Zip Code:
Email:

3rd Reference

Company Name:
Contact Name:
Account No.:
Phone No.:
Street Address:
City, State, Zip Code:
Email:

Certification & Signatures

You represent you are an authorized representative with the authority to enter into this agreement and the information contained in this application and any attachment is true, correct and complete. You consent to Rhea Designs Inc. obtaining information about you personally and the applicant from credit reporting agencies and other sources Rhea Designs Inc. deems appropriate in considering this application. If credit is extended, you agree to be bound by all terms and conditions on Rhea's invoices and posted on RheaDesignsInc.com.

Signature:

Date:

Print Name:

Title: