Fill out the form below, print it and send it by fax to 819 762-2325 or by mail to open an account with Dynamik Equipment. You can also contact us |
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Company Name : |
In business since : |
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Type of industry : |
Estimated Annual Purchases : |
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Legal Structure : Corporation Company N/C Owner Division |
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Billing Address : |
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Province : |
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Email : |
Purchase Order Number Required : Yes No |
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Shipping Address (if different) : |
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Phone : |
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NAMES OF MAJOR SHAREHOLDERS |
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Last Name : |
First Name : |
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Names of major shareholders : |
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Last Name : |
First Name : |
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Names of major shareholders : |
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Last Name : |
First Name : |
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Names of major shareholders : |
Phone : |
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BANK REFERENCES |
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Bank name : |
Name of Contact Person : |
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Branch : |
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Checking Account Number : |
Transit Number : |
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REFERENCES TO COMMERCIAL CREDIT |
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Company Name : |
Name of Contact Person : |
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Address : |
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Phone : |
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Terms and conditions | ||
THE SIGNATORY (S) HAS (HAVE) READ AND ACCEPTED (NT) THE FOLLOWING TERM AND CONDITIONS:
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Title : |
Print Name : |
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Province : |
Date : |
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Signature (owner or manager authorized) : |
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In considérationde granting a line of credit Equipment Dynamik customer, I (we) the applicant (s) (s) personally and jointly guaranteed (are) the payment of any sum due or to be caused by Dynamik Equipment the client. I agree (we accept). |
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Signature of Owner or (to) shareholder(s) authorized(s) : |
Print Name : |
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Date : |
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