Imtek Environmental Corporation-Online Credit Application

Please fill out form completely and carefully.
If you have difficulties, send e-mail directly to: IMTEK

ADDRESS

Name:
Title:
Company:
Address:
City:
State:
Zip:
Country:
Phone:
FAX:
E-mail:

PRINCIPALS (if corporation, list officers, if partnership, list partners)

1.Name
Title
Home Address
City
State
Zip
Country
Phone

2. Name
Title
Home Address
City
State
Zip
Country
Phone

3.Name
Title
Home Address
City
State
Zip
Country
Phone

SALES TAX STATUS

Not Tax Exempt
Tax Exempt --- Exempt #

BANK REFERENCE

Bank Officer
Bank Name
Address
City
State
Zip
Country
Phone
Account #

TRADE REFERENCES

1. Contact Name
Company
Address
City
State
Zip
Country
Phone
2. Contact Name
Company
Address
City
State
Zip
Country
Phone
3. Contact Name
Company
Address
City
State
Zip
Country
Phone

BUSINESS INFORMATION

Individual
Partnership
Corporation

Type of Business
Number of Employees
Years in Business
Annual Sales $
D+B Listed? Yes    No
Amount of Credit Requested $

BY COMPLETING THIS APPLICATION FOR CREDIT, THE APPLICANT:

1. Attests financial responsibility, ability and willingness to pay all invoices
in accordance with the following terms: 2% 30; Net, 30 days, service charges will be
paid at the rate of 1.5% (18% annual rate) on all balances over 30 days.

2. Hereby Authorizes IMTEK ENVIRONMENTAL CORP. to investigate
the references listed pertaining to the applicant's credit and financial responsibility and
obtain additional information by securing data from a credit reporting agency.

3. Hereby Agrees that should it become necessary to assign the applicant's
account to a licensed collection agency or atttorney for legal action, all subsequent
collection charges and legal fees shall be paid by the applicant.

4. Hereby Authorizes the seller, its successors and assigns, by the seller's
designated attorney to waive the issuance of process and confess judgment against the
applicant for the entire unpaid balance of applicant's account together with all costs
applicable to such action.

5. Certifies and Warrants that the information given in this application is true and
correct and is given for the purpose of obtaining credit.

Applicant Name
Position
Date
Applicant Name
Position
Date


Home >> Partners >> Imtek Environmental Corporation-Online Credit Application

 
FREE Online Subscription
Register to receive a FREE subscription to our popular Online MSDS, Sustainability & EHS Solutions. No Downloads, No Software Installation, No Cost, No Risk >>More
Limited Time Special Offer
When you subscribe to our robust Online MSDS Management Solution, you will receive our popular Online Safety Training Solution with over 50 interactive EHS courses FREE! >>More
Why Online or SaaS Solutions are Superior to Software
What is it that makes Online MSDS, Training, Sustainability & EHS Solutions not just different, but better & more cost effective than conventional software? >>More
Carbon Footprint Calculators
Personal Footprint
Business Footprint
Application Specific
GreenHouse Gas carbonfootprint   Recycling carbonfootprint   Waste Reduction carbonfootprint
EHS Business Opportunity
We are seeking strategic global partners to market our Online MSDS, EHS & Sustainability Solutions. Please contact us for more info.
Newsletter Signup
Green Collar Jobs
Follow us on the web:

Facebook

YouTube

Twitter

Linkein

MySpace

Stumble

RSS

Digg