Page 1 of 2 Online Credit Application Please complete all required fields! CONTACT INFORMATION FIRST NAME* Invalid Input LAST NAME* Invalid Input PHONE #* Invalid Input XXX-XXX-XXXX EMAIL* Invalid Input HOW WOULD YOU LIKE TO SUBMIT THE APPLICATION?* BY FILLING AN ONLINE FORM (CONTINUED)BY UPLOADING AN EXISTING PDF FILE Invalid Input BUSINESS INFORMATION NAME OF BUSINESS* Invalid Input LEGAL (IF DIFFERENT) Invalid Input ADDRESS* Invalid Input CITY* Invalid Input PROVINCE/STATE* Invalid Input POSTAL/ZIP CODE* Invalid Input PHONE #* Invalid Input XXX-XXX-XXXX FAX #* Invalid Input XXX-XXX-XXXX E-MAIL ADDRESS* Invalid Input WEBSITE* Invalid Input DESCRIPTION OF BUSINESS P.S.T. LICENSE#* Invalid Input CREDIT REQUESTED* Invalid Input DATE OF INCORPORATED OR ACTIVE PERIOD* Invalid Input BUSINESS STRUCTURE* CORPORATIONPARTNERSHIPPROPRIETORSHIPDIVISION/SUBSIDIARY Invalid Input PARENT COMPANY Invalid Input BANK REFERENCES NAME OF BANK* Invalid Input CONTACT NAME* Invalid Input BRANCH* Invalid Input ADDRESS* Invalid Input ACCOUNT#* Invalid Input PHONE #* Invalid Input XXX-XXX-XXXX ACCOUNTANT’S DETAILS NAME* Invalid Input PHONE #* Invalid Input XXX-XXX-XXXX LAWYER’S DETAILS NAME* Invalid Input PHONE #* Invalid Input XXX-XXX-XXXX DUNN INFORMATION DUNN NUMBER* Invalid Input COMMERCIAL REFERENCES (3 REQUIRED) NAME OF BUSINESS* Invalid Input CONTACT NAME* Invalid Input ADDRESS* Invalid Input CITY* Invalid Input PROV./STATE* Invalid Input PHONE #* Invalid Input XXX-XXX-XXXX NAME OF BUSINESS* Invalid Input CONTACT NAME* Invalid Input ADDRESS* Invalid Input CITY* Invalid Input PROV./STATE* Invalid Input PHONE #* Invalid Input XXX-XXX-XXXX NAME OF BUSINESS* Invalid Input CONTACT NAME* Invalid Input ADDRESS* Invalid Input CITY* Invalid Input PROV./STATE* Invalid Input PHONE #* Invalid Input XXX-XXX-XXXX UPLOAD EXISTING FORM(-S) Maximum file size: 2MB. Allowed extensions: PDF, PNG, JPG FILE #1* Invalid Input FILE #2 Invalid Input FILE #3 Invalid Input CONFIRMATION OF INFORMATION ACCURACY AND RELEASE FOR AUTHORITY TO VERIFY* It is understood and agreed that all invoices will be paid within terms: Net 30 days. When failure to do so occurs, interest is charged on overdue accounts and Winmagic Inc. has the right to place a lien on materials until such accounts are settled. It is also understood that Winmagic Inc. will make every reasonable effort to avoid loss or damage to materials, but liability is limited to the stock cost of the original materials. I hereby certify that the information in this credit application is correct. Please select/check the field if you confirm the accuracy of application. GO BACKSubmit Application