Locks MA 141 GENERAL INFO PGS 1 29 Customer Information/Open Account Application 3 4a
User Manual: Locks Customer Information/Open Account Application Mayflower Sales - Your Source for Architectural Hardware & Locksmith Supplies
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MA-141 GENERAL INFO PGS 1-29 1/16/03 4:04 PM Page 3 M AY F L O W E R S A L E S C O M PA N Y, I N C . Customer Information/Open Account Application General Information Date: ___________________________________________ Please print or type: Company Name: ___________________________________________________________________________________________________ ❏ Proprietorship ❏ Partnership ❏ Corporation State: ______________ General information email: ____________________________________________ Trade Name (if different than above): _____________________________________________________________________________________ Address:_______________________________________ City: _________________________ State: _____________ Zip:______________ Telephone:________________________________________________________ Fax: ____________________________________________ Contact Person: _____________________________________________________________________________________________________ Accounts Payable Contact: __________________________________________ Extension: _______________________________________ E-mail _________________________________________________ Ship To (if different than above): _________________________________________________________________________________________ Address:_______________________________________ City: _________________________ State: _____________ Zip:______________ Telephone:________________________________________________________ Fax: ____________________________________________ Contact Person: _____________________________________________________________________________________________________ If corporation please supply the following infor mation regar ding of ficers: Name: __________________________________________________ Name:__________________________________________________ Address: ________________________________________________ Address: ________________________________________________ City:___________________________ State: _____ Zip: ________ City:___________________________ State: _____ Zip: ________ Title: ______________________________ Soc. Sec. ____________ Title: ______________________________ Soc. Sec. ___________ Name: __________________________________________________ Address: ________________________________________________ City:___________________________ State: _____ Zip: ________ Title: ______________________________ Soc. Sec. ____________ Name:__________________________________________________ Address: ________________________________________________ City:___________________________ State: _____ Zip: ________ Title: ______________________________ Soc. Sec. ___________ Resale/Exempt Number (r equir ed): ______________________ D & B #: _______________________________________________ For additional shipping locations, please attach a separate sheet. Circle the answer which applies: Does your company accept backorders? Does your company require purchase orders? YES YES NO NO SOMETIMES Please fill out this application as completely as possible to avoid delays in shipping orders. Fax application to (718) 789-8346. (Over) 3 MA-141 GENERAL INFO PGS 1-29 1/16/03 General Information 4:04 PM Page 4 M AY F L O W E R S A L E S C O M PA N Y, I N C . Customer Information/Open Account Application (Continued from front) Circle one of the following which best describes your business: 1. Locksmith/Hardware 4. Doors/Storefronts 3. Electrical/Alarm 5. Safe Sales 6. Contractor 7. Automotive 8. Other: ______________________ To establish an open account, please supply the following infor mation and sign below. Bank Name:_______________________________________________________ Telephone: ______________________________________ Address: __________________________________________________________ Checking Account:________________________________ Please list the name, addr ess, telephone, fax and account number for five trade related businesses with whom you curr ently have open account status. Company Name: _______________________________ Telephone: ___________________________ Fax. _________________________ Address:_______________________________________ City: _________________________ State: _____________ Zip:______________ Account Number: __________________________________________________ Contact: _________________________________________ Company Name: _______________________________ Telephone: ___________________________ Fax. _________________________ Address:_______________________________________ City: _________________________ State: _____________ Zip:______________ Account Number: __________________________________________________ Contact: _________________________________________ Company Name: _______________________________ Telephone: ___________________________ Fax. _________________________ Address:_______________________________________ City: _________________________ State: _____________ Zip:______________ Account Number: __________________________________________________ Contact: _________________________________________ Company Name: _______________________________ Telephone: ___________________________ Fax. _________________________ Address:_______________________________________ City: _________________________ State: _____________ Zip:______________ Account Number: __________________________________________________ Contact: _________________________________________ Company Name: _______________________________ Telephone: ___________________________ Fax. _________________________ Address:_______________________________________ City: _________________________ State: _____________ Zip:______________ Account Number: __________________________________________________ Contact: _________________________________________ Signature:_________________________________________________________ Position: ________________________________________ For office use only: Inquiries 1 2 3 Response ❏ ❏ ❏ CL: __________ Appr oved: _______________ 4 Toll Free: (800) 221-2052 http://www.mfsales.com ■ ■ Our ter ms ar e Net 30. A late char ge of 1-1/2% per month is char ged on all balances over 60 days. Phone: (718) 622-8785 ■ Fax: (718) 789-8346 e-mail: pilgrim@mfsales.com
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