Apply for Net 30 Days Terms, Takes up to 3 1/2-4 Weeks to Approve. Email onesourcesupplies@outlook.com or Fax to: 1-206-339-7521

1. Credit Application Form for New Accounts
Legal Name: __________________________________________Trade Name (if different): ______________________________________________
Bill To Address: ________________________________________________________________________________ Unit or Suite #: _____________
City: _____________________________________________________________________ Province: ___________Postal Code: _________________
Ship To Address (if different):_______________________________________________________________________Unit or Suite #: _____________
City: _____________________________________________________________________ Province: ___________Postal Code: _________________
Name of Buyer: _________________________________Telephone: _______________________ Ext.: ________Fax: ________________________
Buyer e-mail address: ______________________________________________________________________________________________________
Type of Business: ______________________________________ Number of employee’s: ________
Business Classification: Proprietorship Partnership Corporation in business since: _________________
Purchase Orders Required: Yes No HST or Business Number if Required #: _______________________________________________
Invoice in e-mail: Yes No Invoice by Fax: Yes No
A/P Contact: ___________________________________Telephone: _______________________ Ext.: ________Fax: ________________________
A/P e-mail address: ________________________________________________________________________________________________________
Charge to your credit card Yes No Card Type: Visa M/C Amex
Card Number: _______________________________________________ Expiry Date: ____________/__________
Your Financial Institution: ___________________________________________________ Branch: _______________________________________
Telephone No.: _____________________________Fax No.: ___________________________ Contact: ____________________________________
Trade References (Please Print Clearly)
(1) Company: _______________________________________________Tel: ( )____________________ Fax: ( )____________________
(2) Company: _______________________________________________Tel: ( )____________________ Fax: ( )____________________
(3) Company: _______________________________________________Tel: ( )____________________ Fax: ( )____________________
We the above authorize One Source to make the usual credit inquiries regarding the credit applied for and consent to the disclosure of any information to
any credit operating agency or firm with whom the undersigned may have financial dealings. All invoices are due and payable in full on/before the 30th
day
from the date of the invoice.