Credit Application

COMPANY OFFICER OR ACCOUNTING MANAGER MUST SIGN THIS FORM. TO EXPEDITE CREDIT CHECK PLEASE PROVIDE AN EMAIL ADDRESS FOR BANK AND TRADE REFERENCES. LIST USA TRADE REFERENCES THAT HAVE EXTENDED CREDIT IN AN AMOUNT THAT IS SIMILAR TO THE AMOUNT THAT YOU ARE SEEKING.

* Required Fields

Conset to Contact *

I authorize Canflex (USA) Inc. and its representatives to contact the trade and bank references listed below for the purpose of evaluating this credit application.

COMPANY INFORMATION

Legal Name & DBA *

Business Type *

Corporation LLC Partnership Sole Proprietorship

Address *

Phone *

Contact Name / Accounts Payable *

Email *

Amount of Credit You Are Seeking *

Net Terms Requested*

Your Requested Terms

Years in Business *

Federal ID # *

9-Digit Dun & Bradstreet # *

Sales Tax Exemption # *

BANK REFERENCE

Name of Bank *

Phone *

Bank Contact Person *

Bank Contact Phone *

Email *

Bank Account # *

TRADE REFERENCES (Minimum of 3 current U.S. suppliers who have extended similar credit. Please include: company name, contact person, address, phone, email, and length of relationship.)

Reference 1 *

Reference 2 *

Reference 3 *

IF CREDIT IS OPENED WITH CANFLEX USA, INC., YOU AGREE, BY COMPLETING AND SIGNING THIS APPLICATION, TO PAY WITHIN OUR TERMS OF NET 30 DAYS. IF PAYMENT TERMS ARE NOT MET, YOU AGREE TO PAY INTEREST CHARGES OR FEES ASSOCIATED WITH COLLECTIONS.

Signature *

Date *

Printed Name *

Title *

Upload W-9 Form (PDF) *

Upload Tax Exemption Certificate (if applicable)

Accepted file formats: PDF, JPG, or PNG. Maximum size 10 MB.