Account on Hold Over Credit Limit - Excel by akg31466


Account on Hold Over Credit Limit document sample

More Info
									                                  Northern Contours                                                     Date:
                                  New Account Information
                                  Submit completed form to Fax: 651-695-1714 or Email:

Company Name:

Billing Address

City                                                                      State                             Zip

DBA (if applicable):

Shipping Address

City                                                                      State                             Zip

                    Residential                      Commercial

Contact #1                                                                Contact #2

Title                                                                     Title

Phone                                 Fax                                 Phone                                    Fax

Email                                                                     Email

Orders/Shipping Info
1. How will the orders be placed?                     Fax                  Email*

         *If orders will be placed by email, please make sure an email address is listed above.

2. How will orders be paid for?              Credit Card Only            Account (please fill out a credit application)       Prepay

3. Is there a loading dock for pallet delivery?               YES                 NO

4. Is there a forklift?               YES                NO

Type of Account (Select ONLY One)

         Stock Cabinets                     Commercial Refacing                           Hospitality                     Office

         Custom Cabinets                    Residential Refacing                          Healthcare                      Store Fixture

         Home Org.                          Manufactured Housing                          Architectural Millwork

         Distributor                        Other:                                        Misc F&F

Credit Limit Assigned                                                             Sales Rep

Account Number Assigned

Notes:   Account balances are past due at 30 days. At 45 days, orders will be placed on hold.
         Any balance over 60 days may result in collection measures.                                                                      Oct-08

To top