UFPC Parts by sej19662

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Reseller Application Letter document sample

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									                                                                                                                                  UFPC Parts
                                                          CREDIT APPLICATION                                                      Connection


Date:                                                              Requested Credit Limit                                  Number of Years
                                                                                                                           in Business
Company Name:
                                                                                                                           DUNS #
Address:
                                         Street Address Line 1
                                                                                                                           Ownership Type:
                                                                                                                                  Corporation
                                         Street Address Line 2
                                                                                                                                  Partnership
                                                                                                                                  Proprietorship
                                         City                                 State          ZIP

Contact Name:                                                                                                 Phone:
Contact E-Mail:                                                                                               Fax:

Banking References:
      Bank Name:                                                                                                                  Bank Contact
      Bank Address:                                                                                               Name
                                         Street Address
                                                                                                                  Phone
                                                                                                                    Fax
                                         City                                 State          ZIP
                                                                                                                   Email
      Bank Account#


Trade References:
  1) Name                                                                                          Address:
      Phone#
   2) Name                                                                                         Address:
       Phone#
   3) Name                                                                                         Address:
       Phone#
   4) Name                                                                                         Address:
       Phone#


Sales Tax Exemptions:
 1) Are you a tax exempt organization (government entity, not-for-profit, church, etc)?                                                  Yes       No
            If Yes, please provide exempt organization certificatation prior to ordering (or sales tax will be charged).
   2) Are you a reseller of products you will be purchasing, requesting exemption from sales tax?                                        Yes       No
            If Yes, please provide reseller exemption certificatation prior to ordering (or sales tax will be charged).
   3) Are you an end user of products you will be purchasing, subject to sales/use tax?                                                  Yes       No
            If Yes, you will be charged applicable sales tax based on ship-to destinations of shipped orders



Authorization:
I authorize UFPC Parts Connection. to contact the above provided bank and trade credit references for the purpose of making credit decisions
on my customer/purchasing account. Additionally, upon UFPC Parts Connection's approval of this credit application, I agree to abide by the
payment terms (net 30 days) disclosed in the "Terms and Conditions" letter, under separate cover.


Signature of authorized representative                                       Title                                         Date




Application Submission:
   Fax Completed Application to:                                 866-868-5889 Attn: UFPC Part Connection Credit
   or E-Mail to:                                                 info@ufpcpartsconnection.com

								
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