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Announcements

                                                         

                                                               

               

                                                                             Company Name: 

                                                                              Mail Address 1: 

                                                                              Mail Address 2: 

                                                                              Mail Address 3: 

                                                                                              City:      State:  

                                                                                       Zip Code  URL: 

                                                                                    Telephone:    Fax:   

                                                                                           E-Mail:   

                                                                                  Company is:  Sole Proprietor Partnership Corporation LLC

                                                                                        Officers:           

                                                                                        Officers:              

                                                                                        Officers:     

                                                                                       FED ID #:   Resale #:    

Main Accounts Payable Contact:      Telephone: 

 Bank Name:       Bank Contact:                            

Trade Reference Name:    Contact:    Telephone:                  

Trade Reference Name:    Contact:    Telephone:   

Trade Reference Name:    Contact:    Telephone:   

By submitting this request for credit terms, I agree to the terms and conditions established by Certified Metals Incorporated, and authorize Certified Metals to contact any and all parties listed in the evaluation process of establishing credit terms.

Submitted by:    Date:  

Telephone:     Fax: