6 2021. Complete the credit application in full online at: ... Yes □ No □ (If yes please provide the copy of certificate and fill out CRT 61).
Installation Support • No Nonsense™ Warranty • (800) 875-5285 • www.WarmlyYours.com Credit Application 6 2021 Complete the credit application in full online at:
Credit Application Complete the credit application in full online at: https://www.warmlyyours.com/en-US/trade/credit-application Or scan and email to: info@warmlyyours.com WarmlyYours Credit Department 590 Telser Rd Lake Zurich, IL 60047 FAX: (800) 408-1100 Phone: (800) 875-5285 Your company's annual total in sales: Amount of employees: Amount of store locations: How many floor heating jobs sold : General information Company Name______________________________ Address__________________________________________________ City______________________ State_______________Zip___________ Phone_________________ Fax________________ Billing Address___________________________________________________________City__________________________ State_________________________Zip____________________Phone_____________________Fax___________________ Business Start Date__/__/____Type of Business______________________DBA Name_______________________________ Is Merchandise for resale? Yes No (If yes please provide the copy of certificate and fill out CRT 61) Federal ID number_____________________________________________________________________________________ Please check and complete as applicable below: Proprietorship Partnership Corporation Principle/Owner________________________________________Title____________________________________________ Phone____________________Fax__________________Contact email___________________________________________ Do you have a parent company? Yes No If yes, provide parent company name and location:____________________________________________________________ ____________________________________________________________________________________________________ Ordering information Purchasing agent_________________________Fax________________Email_______________Phone__________________ Account payable contact____________________Fax________________Email______________Phone__________________ Open Account Trade References (3 required and please include FAX Number) 1. Name________________________________Address_______________________________________________________ City________________________State_____________Zip_________Phone_________________Fax_________________ 2. Name________________________________Address_______________________________________________________ City________________________State_____________Zip_________Phone_________________Fax_________________ 3. Name________________________________Address_______________________________________________________ City________________________State_____________Zip_________Phone_________________Fax_________________ Bank Information Bank Name_______________________________Bank contact officer____________________________________________ Bank address_______________________________City______________________State_______________Zip___________ Type of Account _____________________________Account Number_____________________________________________ Phone___________________________________Fax_________________________________________________________ We hereby certify that all statements in this application are true and complete and are made for the purpose of obtaining credit. If our account is not paid as agreed according to the invoice, we promise to pay the unpaid balance and to reimburse all costs of collection. Print Name________________________________________Title_______________________________________________ Signature_________________________________________Date_______________________________________________ Installation Support · No NonsenseTM Warranty · (800) 875-5285 · www.WarmlyYours.com 6 2021Adobe Illustrator 25.2 (Macintosh) Adobe PDF library 15.00