ST. PETE BLUE
MEASURING TAPES • MEASURING WHEELS
ARCHITECTURAL SUPPLIES • MAPS • ENGINEERING SUPPLIES
POST OFFICE BOX 425 • ST. PETERSBURG, FL 33731-0425
(727) 822-3652 • FAX (727) 322-5375

APPLICATION FOR CREDIT
Print this form and FAX to us, or download it in .pdf format

COMPANY NAME:_________________________________________________________

STREET ADDRESS:________________________________________________________

CITY:__________________________________ STATE:_____ ZIP CODE:_____________

MAILING ADDRESS:_______________________________________________________

CITY:__________________________________ STATE:_____ ZIP CODE:_____________

PHONE (Local):_____________________ (Corporate Office):_______________________

FAX (Local):______________________ (Corporate Office):_________________________

COMPANY STRUCTURE (circle one):
PROPRIETORSHIP

PARTNERSHIP

CORPORATION

NUMBER OF YEARS IN BUSINESS ________

OWNERSHIP:    

NAME:_______________________________ TITLE:______________________________

NAME:_______________________________ TITLE:______________________________

PURCHASING CONTACT:___________________________________________________

ACCOUNTS PAYABLE CONTACT:____________________________________________

TAX EXEMPT - YES___ NO____ TAX NO.______________________________________

MAY WE CONTACT YOU BY E-MAIL OR FAX FROM TIME TO TIME? (please circle)

NO

FAX

E-MAIL

TRADE REFERENCES - NAME, ADDRESS & TELEPHONE (& FAX, if known)

(1)__________________________________________________________________________

____________________________________________________________________________

(2)__________________________________________________________________________

____________________________________________________________________________

(3)__________________________________________________________________________

____________________________________________________________________________

AUTHORIZED SIGNATURE__________________ TITLE_____________DATE_______

OUR TERMS ARE NET 30 DAYS FROM STATEMENT DATE.
ACCOUNTS ARE PUT ON "CREDIT HOLD" UNTIL THE ACCOUNT IS PAID CURRENT. IF THIS ACCOUNT REMAINS IN ARREARS AT 60 DAYS, CUSTOMER AGREES TO PAY ALL REASONABLE COLLECTION FEES SHOULD IT BE NECESSARY TO TURN IT OVER FOR COLLECTION.

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