Commercial Credit Application Form - American Residential Services

ADVERTISEMENT
Submit by Email
Print Form
American Residential Services, LLC
965 Ridge Lake Blvd; Ste. 201
Memphis, TN 38120
901‐271‐9938
Attention: Chris Montgomery
COMMERCIAL CREDIT APPLICATION
creditapps@ars.com
BUSINESS CONTACT INFORMATION
Company Name:
DBA:
Parent Company:
Company Address:
Time at Present Location?
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
Date business commenced:
Sole proprietorship:
Partnership:
Corporation:
LLC:
Franchise:
Nature of Business:
President/Owner:
Federal Tax ID/SS#:
BUSINESS FINANCIAL INFORMATION
Billing Address:
Accounts Payable Contact:
City:
State:
Zip Code:
Telephone:
Fax:
E-Mail:
Yes
Yes
Tax Exempt?
Ever Filed Bankruptcy?
If yes, how long ago?
Bank Name:
Branch:
Bank Address:
Phone:
City:
State:
Zip Code:
Checking Acct #:
Savings Acct #:
Other:
Primary Account Holder:
Years with Institution:
PURCHASE ORDER AND INSURANCE
Yes
Yes
PO Required?
Workman’s Compensation?
Yes
General Liability?
BUSINESS/TRADE REFERENCES
1. Company name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
2. Company name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
3. Company name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
AGREEMENT
1. All invoices are to be paid 30 days from the date of the invoice.
2. By submitting this application for credit, you authorize YOUR COMPANY NAME or affiliate, to make any inquiries
necessary to determine credit worthiness. In addition, to the best of your knowledge the above information is
complete and accurate as of the date of this application.
SIGNATURES
Authorized Signature:_____________________________________ Date:______________________________
Print Name:______________________________________________ Title:______________________________
Submit by Email
Print Form
American Residential Services, LLC
965 Ridge Lake Blvd; Ste. 201
Memphis, TN 38120
901‐271‐9938
Attention: Chris Montgomery
COMMERCIAL CREDIT APPLICATION
creditapps@ars.com
BUSINESS CONTACT INFORMATION
Company Name:
DBA:
Parent Company:
Company Address:
Time at Present Location?
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
Date business commenced:
Sole proprietorship:
Partnership:
Corporation:
LLC:
Franchise:
Nature of Business:
President/Owner:
Federal Tax ID/SS#:
BUSINESS FINANCIAL INFORMATION
Billing Address:
Accounts Payable Contact:
City:
State:
Zip Code:
Telephone:
Fax:
E-Mail:
Yes
Yes
Tax Exempt?
Ever Filed Bankruptcy?
If yes, how long ago?
Bank Name:
Branch:
Bank Address:
Phone:
City:
State:
Zip Code:
Checking Acct #:
Savings Acct #:
Other:
Primary Account Holder:
Years with Institution:
PURCHASE ORDER AND INSURANCE
Yes
Yes
PO Required?
Workman’s Compensation?
Yes
General Liability?
BUSINESS/TRADE REFERENCES
1. Company name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
2. Company name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
3. Company name:
Address:
City:
State:
Zip Code:
Phone:
Fax:
E-mail:
AGREEMENT
1. All invoices are to be paid 30 days from the date of the invoice.
2. By submitting this application for credit, you authorize YOUR COMPANY NAME or affiliate, to make any inquiries
necessary to determine credit worthiness. In addition, to the best of your knowledge the above information is
complete and accurate as of the date of this application.
SIGNATURES
Authorized Signature:_____________________________________ Date:______________________________
Print Name:______________________________________________ Title:______________________________

Download Commercial Credit Application Form - American Residential Services

215 times
Rate
4.3(4.3 / 5) 11 votes
ADVERTISEMENT