Fillip Metal Cabinet Co by e2f57F39

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									  Fillip Metal Cabinet Co., Inc.
  4500 W. 47th St.
  Chicago, IL 60632                                                        Credit Application
  773-826-7373              Fax: 773-826-6420

Please note processing a credit application can take up to 10 business days or longer. If you have an order that needs to be
expedited, please call our customer service department for other options available.

Billing Address:
  Legal Name

  DBA

  Address

  City                                                                            State                                       Zip

  Telephone                                                   Fax                                                             E-Mail

Shipping Address:
  Legal Name

  DBA

  Address

  City                                                                            State                                       Zip

  Telephone                                                   Fax                                                             E-Mail

Company Information:
  Primary Business Activity                                                           SIC Code                                                    Monthly Credit Limit Desired

  Date Business Established                                                 Dun & Bradstreet Number                                               D&B Rating

  Legal Entity (Check One)                          Corporation                    Partnership                     Sole Ownership
  Date of Incorporation                          State of Incorporation                                             Federal Tax ID

Principals of the Company:
                     Name                                                         Address                                                       Title/Home Phone




Will you provde a financial statement if requested? Yes / No
If No, please explain: ___________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________


Freight Damage Policy. If Fillip is allowed to use the carrier of it’s choice and there is damage to the product, Fillip will reimburse you the difference in the carrier settlement on
the item purchased as long as the damage is noted on the freight receiving ticket. If you choose the carrier, any freight damage, including but not limited to concealed damage, is
between you, your company, and your freight carrier. Fillip will not accept any liability. For complete details contact your sales representative.

Certification. The underisgned understands and agrees that all invoices are due thrity days from date of shipment and that any invoices not paid within the terms stated are subject
to a 2% service charge per month (24% per annum) and agrees to pay these charges in the event of default. In the event legal action is instituted to enforce payment of the amount
due pursuant to the extension of credit, the undersigned agrees to be liable for all attorney;s fees, costs and expenses of collection, as well as legal interest from the date the original
amount was due.


Company Name                   ____________________________________

Name (please print) ____________________________________

Signature                       ____________________________________ Title ______________________ Date ______________
                                             Credit References
Please provide four trade references and one banking reference. List companies from whom you have purchased within the
last six months. Do not use companies under the same ownership as your company, utility vompanies, freight carriers, or
vendors from whom you purchase on consignment.

Credit Reference #1
 Name                                                                                         Account Number

 Address

 City                                                                               State             Zipcode

 Telephone                                               Fax                        Contact

 Nature of this business                                                 How long have you been buying from this vendor?


Credit Reference #2
 Name                                                                                         Account Number

 Address

 City                                                                               State             Zipcode

 Telephone                                               Fax                        Contact

 Nature of this business                                                 How long have you been buying from this vendor?


Credit Reference #3
 Name                                                                                         Account Number

 Address

 City                                                                               State             Zipcode

 Telephone                                               Fax                        Contact

 Nature of this business                                                 How long have you been buying from this vendor?


Credit Reference #4
 Name                                                                                         Account Number

 Address

 City                                                                               State             Zipcode

 Telephone                                               Fax                        Contact

 Nature of this business                                                 How long have you been buying from this vendor?



Banking Reference
 Name of Bank                                                                                 Account Number

 Address

 City                                                                               State             Zipcode

 Telephone                                               Fax                        Banking Officer

 Account Number                         Account Type    Checking       Business
                                                        Savings        Personal

								
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