Triangle Blue Print - Credit Application

CREDIT APPLICATION

Instructions: Please print this page and mail or fax it to us. Fax: (409) 835-6645
Printing instructions: Seclect 'File' and 'Print Frame' on your browser.

GENERAL INFORMATION
Business Name: _________________________________________________________________________
Billing Address: __________________________ ____________ ____________ ____________ street city state zip code Physical Address: ________________________ ____________ ____________ ____________ street city state zip code Phone #: _______________ Fax #: _______________ Years in business: __________________
Corporation ; Sole Proprietorship; Partnership;
If Corporation, List Officers: _____________________________________________________
BUSINESS CREDIT REFERENCES (minimum of three)
Name Address Phone # Fax # _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________ _________________
SALES TAX INFORMATION
Taxable ;

Tax Exempt ;

Limited Tax Permit ;

TX Sales Tax Permit #:

______________

(must be completed)

If tax exempt, we will mail an exempt certificate that should be completed by your company & returned immediately for our records.
Reason Claiming Exemption: Resale ; U.S. Government Agency ; State, City or County Agency or School ; Religious, Charitable, or Educational created as a Non-Profit Organization .
Are Purchase Orders required? Yes No
Name of person regarding Accounts Payable: ________________________________________

Applicant agrees that the extension of credit by the seller shall be subject to and in consideration of the following:
1. Terms are net 30 days of invoice date.
2. The undersigned authorizes the above mentioned references to release the information requested by Triangle Blue Print Co.
3. Sales Tax will be charged until validly issued exempt certificate is received.
4. The undersigned agrees to the terms and conditions stated herein.

Triangle Blue Print Co.
1123 Calder
Beaumont, Texas 77701
(409) 835-6810
FAX: (409) 835-6645

Signature:_______________________________________________
Name:__________________________________________________
(type or print)
Title:___________________________________________________
Date:__________________________________________________

Billing Address:	__________________________		____________	____________	____________
	street		city	state	zip code

Physical Address:	________________________		____________	____________	____________
	street		city	state	zip code

Name	Address	Phone #	Fax #
_________________	_________________	_________________	_________________
_________________	_________________	_________________	_________________
_________________	_________________	_________________	_________________
_________________	_________________	_________________	_________________

Taxable ;	Tax Exempt ;	Limited Tax Permit ;	TX Sales Tax Permit #:	______________
				(must be completed)