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c-global.com Credit Application

In making this application, I/we understand that all accounts, unless otherwise arranged are payable according to the terms set by c-global.com. If not paid on or before terms stated the account will be considered delinquent. I/we agree to personally guarantee payment of all invoices and legal service charges added each month on past due invoices.

  Allow an additional 48-72 hours delivery time to process this application (first order only).

Please provide the following information.       (* = Required Information)

Corporate Name *
Trade Name  
E-mail *
URL
BILLING
Street Address *
City * State * Zip Code *
Phone *

FAX

Contact *

Title


Are Billing & Shipping Information the same?   *
Shipping    ( * If different from above)
Street Address
City State Zip Code

    Choose one of the following options:*   Year established  *

           Are you tax exempt ?  *

           If "YES" please provide Sales Tax ID # *

If a Corporation, please list officers:

Name *

Title

*
Name

Title

Name

Title

If not a Corporation:

Social Security # (* required if not a Corporation)
Drivers License # (* required if not a Corporation)

Trade References:

Name *

Address

*
Phone *

Fax

Name *

Address

*
Phone *

Fax

Name

Address

Phone

Fax

Bank Information:

Bank *

Account #

*
Branch

Phone

*
Officer *

 

Submitted by: * Title *