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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General

Information

MAYFLOWER SALES COMPANY, INC.

Customer Information/Open Account Application

Please print or type: Date: ___________________________________________

Company Name: ___________________________________________________________________________________________________

❏Proprietorship ❏Partnership ❏Corporation State: ______________

Trade Name (if different than above):_____________________________________________________________________________________

Address:_______________________________________ City: _________________________ State: _____________ Zip:______________

Telephone:________________________________________________________ Fax: ____________________________________________

Contact Person: _____________________________________________________________________________________________________

Accounts Payable Contact: __________________________________________ Extension:_______________________________________

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: __________________________________________________ Name:__________________________________________________

Address: ________________________________________________ Address:________________________________________________

City:___________________________ State: _____ Zip: ________ City:___________________________ State: _____ Zip:________

Title: ______________________________ Soc. Sec.____________ 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? YES NO SOMETIMES

Does your company require purchase orders? YES NO

Please fill out this application as completely as possible to avoid delays in shipping orders.

Fax application to (718) 789-8346.

(Over)

General

Information

MA-141 GENERAL INFO PGS 1-29 1/16/03 4:04 PM Page 3

E-mail _________________________________________________

General information email: ____________________________________________

General

Information

(Continued from front)

Circle one of the following which best describes your business:

1. Locksmith/Hardware 4. Doors/Storefronts 6. Contractor 8. Other: ______________________

3. Electrical/Alarm 5. Safe Sales 7. Automotive

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 r elated businesses

with whom you curr ently have open account status.

Company Name: _______________________________ Telephone: ___________________________ Fax. _________________________

Address:_______________________________________ City: _________________________ State: _____________ Zip:______________

Account Number: __________________________________________________ Contact:_________________________________________