New Account

Vitres D'autos

Vitre Tech Inc.

 

CONFIDENTIAL CREDIT APPLICATION

(This form must be completed in full in order to be processed)

 

  Legal Trading NAme:  
   
   
  (And/Or) Operating As: 
       
  Business Location: 
       
  Postal Code: 
      Importer Number 
 
  Telephone No: 
      Fax No: 
 
  How Long in Business 
      Type of Business 
 
  Bank: 
      Account No:    
  Adress: 
      Postal Code: 
 
  Telephone No: 
      Fax No:    
       

CREDIT REFERENCES

NAME ADDRESS
PHONE NO.
     
     
     

  Person responsible for A/P:
      E-mail:
   
  Phone:    Fax: 
  Required Credit ($):     

NAME AND ADDRESS OF OWNER(S) OFFICER(S)

NAME
TITLE
ADDRESS
PHONE NO.
       
       


In the event that credit information cannot be obtained throught normal channels, the undersigned authorizes Vitre Tech to contact their financial institution and hereby authorize them to release the information required to establish the necessary credit.

 

The undersigned coveants and agrees to pay to Vitre Tech interest on the overdue amount outstanding to Vitre Tech at the rate of two (2%) per month, twenty-four (24%) per annum.

 

The undersigned shall pay all costs incurred by Vitre Tech in the collection of monies owing to Vitre Tech.

I/We hereby consent to the aforementioned being made or, being caused to be made, by Vitre Tech in connection with my application or my continuing credit

 

  Date:       Name (Please Print):
   
  Company:    Title: 
    by checking off this box, I hereforth validate the information entered

 

 

 

VITRE-TECH INC. 2860, DE MINIAC, ST-LAURENT, QUEBEC H4S 1K9