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									RECKITT BENCKISER INC.
Trade Sector:________
Operating Division: H&CPD______

NEW ACCOUNT/CREDIT APPLICATION
FPD_______ ING_______ SPD_______

Trade Class: ________

DUNS #____________________________

______ NEW ACCOUNT
CUSTOMER SHIP TO #:
SHIP TO: (Official Store Name)

______ CHANGE IN ACCT. INFO
INVOICE TO #:
INV. TO NAME STREET ADDRESS

AMOUNT OF ORDER $_________________

STREET ADDRESS

CITY TELEPHONE NO.: OWNER OR MANAGER'S NAME LIST PARENT COMPANY

ST/PROV

COUNTRY FAX NO.:

ZIP/PC

CITY

ST/PROV

COUNTRY

ZIP/PC

PARENT- A/R #
PAY FROM: ADDRESS

CITY YEARS IN BUSINESS CONTACT NAME

ST/PROV

COUNTRY YEARS AT LOCATION

ZIP/PC

CITY FAX Number EMAIL Address PHONE NUMBER

STATE

COUNTRY

ZIP/PC

Estimated Annual/Monthly Purchases $________________________________
TRADE REFERENCES: LIST 3 REFERENCES FROM WHOM YOU PURCHASE ON OPEN ACCOUNT TERMS
Name Street Address City St Zip Phone Number Fax Number

1

2

3

BANK REFERENCES: (IF SECOND BANK, GIVE INFORMATION ON REVERSE SIDE OF THIS FORM)
BANK NAME STREET ADDRESS ABA # ACCT. #

CITY

ST/PROV

ZIP/PC

NAME OF CONTACT

PH. NUMBER

FAX NUMBER

I authorize above named bank to release information for the purpose of establishing an open line of credit with Reckitt Benckiser. "Signature attests financial responsibility, ability and willingness to pay invoices in accordance with payment terms"
Customer Signature Title
SALESPERSON/BROKER: (Signature) DATE REGION MANAGER (Signature) DATE:

DATE

PLEASE ATTACH CURRENT FINANCIAL STATEMENTS AND TAX EXEMPT CERTIFICATE
CREDIT DEPARTMENT CUSTOMER HOLD YES _____ NO ____ CREDIT LIMIT$___________ CANADIAN CUSTOMERS GST REG # _________________________ QST REG # _________________________ CREDIT DEPARTMENT (Signature) DATE Buying Group Yes or No

CREDIT CHECK: CREDIT LIMIT ________________ PAYMENT TERMS____________ SALES HEADQUARTERS (Signature) DATE

SEND COMPLETED APPLICATION TO: Revised: 4/06/06

RECKITT BENCKISER INC. Attn: Credit Department 1680 Tech Ave Unit2, Mississauga, ON L4W 5S9

FAX: 905-283-7004

RECKITT BENCKISER INC
Credit Application Part II
Customer Name: Street Address: City: State & Zip Code:

Sales
Customer Type: SOT: Adjustment Schedule: Global Customer: Plan To # Plan To Name Cat. Code #28 Code Cust. Disc. Code (CC#14) Trade Name: Trade Sector: Trade Class: Buying OM ID (Comm.) Financial ID Financial Group for GL (JDE - CC#5) Distributor Code (CC#12) BRD CAP CLB ING MST R-D RET SYS

Logistics/Transportation
Warehouse: BCI: Pallet Type: Credit Attorney Account: Military Invoice Code: Military Invoice Copies: Freight Terms: Customer PU Rate:

International Destination Country Code # Invoice Copies Invoice Format Code:

Signatures
Sales: Logistics/Transportation: Date: Credit: International:

TRADE SECTOR A B C D E F G H I J K L M N O P Q Z Grocery Pharmaceutical Discounters Mass Merchants Club Hardware Governnment Commercial Commercial Service Agricultural Institutional Retail Specialty End Use Internal Sales Pharmaceutical Pharmaceutical - Licencees Mixed Sector Unclassified Primary offering is Food Primary offering is Over-The-Counter drugs and personal care items Stores that offer private label and little known brands at deep discounts (Hard Discounters) Low margin, high volume stores offering limited assortment of general merchandise, health & beauty care, and food at a discount Warehouse membership outlets Includes Home Centers, Lawn & Garden Represents Military, Govt agencies Includes Restaurants, Hotels, etc. Services commercial institutions (food service, janitorial ) Represents Farm stores & agricultural suppliers Includes Schools, Hospitals, etc. Includes Perfumery, Sports, Toys, Department Stores Sold direct to consumer RB inter-company sales (Transfers) Dispenses prescription drugs Manages RB pharmaceutical brands, under contract , in specific markets/territories Combination of two or more individual sectors. Example: Boots as a corporate parent which has both OTC and Ethical divisions

TRADE CLASS Retail: Self service outlets selling directly to end-use consumers. 10 11 12 13 14 15 16 17 Retail Hypermarket Retail Superstore Retail Supermarket Retail C-Store Retail Hard-Discounter Retail - Pharmacy <100 Retail - Pharmacy 100+ Retail Drug Market Full line, Size: SF=45,000+/SM=2,500+ Full line, Size: SF=25,000+/SM=800+ Full line, Size: SF=10,000+/SM=400+ Limited Line, small convenience store Limited Line, aggressive low pricing, low margins 1-99 stores 100 or more stores Small stores selling OTC, Personal Care and Household items -- NO pharmacy

Wholesale: A company in the business of buying, warehousing and selling to retailers. 20 Wholesale/Traditional 21 Wholesale/Outlet 22 Wholesale/C & C Sells to retailers, no direct consumer sales Operates own retail outlets in addition to wholesale activities Commercial clientele, cash basis -- no credit facilities ("Cash & Carry"

Distributor: A business which warehouses, ships/invoices products AND provides other service functions to retailers and/or distributors. 30 Distributor 31 Master Distributor Buys RB goods, resells to retail outlets along with merchandising services. Sells to other distributors.

Cooperative: A cooperatively owned group in which small operators band together to gain buying and distribution efficiencies. 40 Co-Op (As defined above)

Independent: Generally a small business operating independently of any group. 50 Independent 99 Unclassified (As defined above)


								
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