CREDIT APPLICATION Please enable JavaScript in your browser to complete this form.Company InformationCompany Name *Brief Description of Business *Physical Address *City *State *Zip *Phone Number *Fax NumberEmail *WebsiteMailing Address (If different from physical)Mailing AddressCityStateZipPurchasing InformationPurchasing Contact Name *Contact EmailContact PhoneShipping & Receiving InformationAccounts Payable Contact *Contact EmailContact Phone *Accounts Payable InformationAccounts Payable Contact *Contact EmailContact PhonePreferred method of receiving invoices : *EmailFaxMailExpected Method of Payment *Open accountCredit cardCODWill purchases be tax exempt? *YesNoPlease upload your tax exemption certificate here or complete the Missouri Form 149 then fax or e-mail it directly to us. Click or drag a file to this area to upload. Please provide a minimum of three and maximum of four referencesReference #1Company Name *Location *Contact Person *Phone *FaxEmail *Reference #2Company Name *Location *Contact Person *Phone *FaxEmail *Reference #3Company Name *Location *Contact Person *Phone *FaxEmail *Reference #4Company Name *Location *Contact Person *Phone *FaxEmail *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 *Single Line TextNameSUBMIT
