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Associated Microsource America,Inc
14414 Valley Blvd,City of Industry, Ca 91746
Tel:(626)333-9658 Fax:(626)333-9262
Credit Application
Form
|
Information |
| Company
Name
Business Phone |
| Billing Address: |
|
Phone:
Fax: E-Mail: |
| Federal TAX
ID: In
Business Years |
|
Phone: Fax
: E-Mail: |
| Commercial Checking
Account Number: |
| Other Commercial Account
Number: |
| Contact
Person: Phone:
Fax: |
| Line of Credit if Any |
|
Ownership Information |
| Name of
Owner: Home
Phone: SSN#: |
| Home Address: |
| Name of
Owner: Home
Phone: SSN#: |
| Home Address: |
| Trade
Reference |
| 1)
Name:
Phone: Fax: |
| Address: |
| 2)
Name:
Phone: Fax: |
| Address: |
| 3)
Name:
Phone: Fax: |
| Address: |
The undersigned agree
to all information in the
credit application are correct,
I hereby guarantee to Associated Microsource America,Inc, the payment of any obligation of company, In the
event payment is not made and this account is referred to
collection. I will pay all collection fees. I promise to pay
reasonable attorney's fees in said suit or action, I authorize Associated Microsource America,Inc to make any all inquires necessary for action
on this credit application.
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