Casway Distributors LLC

 

1-800-479-4731

Credit Application

Please fill out the following form completely. If any field is left blank, your application will not be processed. The only exception is in the Company information, you need to provide only one of the following as a means of identifying your corporation tax status: Federal Tax ID #, or Principal's SSN, whichever applies.

YOUR COMPANY   
Business Type:
President:
Vice-President:
Secretary/Treasurer:
Payment Terms Requested:
Credit Limit Requested:
Company Name:
Year Established:
Number of Employees:
Number of Stores:
Street Address :
 
City:
State:
Zip Code:
Email Address:
Telephone Number :
Facsimile Number :
Federal ID Number :
Tax Resale Number :
Principal's SSN :
Type of Business :
TRADE REFERENCES: Please Complete With Mailing Address - 4 Trade References. Floor Plan Companies, Credit Card, Additional Bank References and Personal References are NOT acceptable.
TRADE REFERENCE 1   
Company Name:
Street Address :
 
City:
State:
Zip Code:
Telephone Number :
Facsimile Number:
TRADE REFERENCE 2   
Company Name:
Street Address :
 
City:
State:
Zip Code:
Telephone Number :
Facsimile Number:
TRADE REFERENCE 3   
Company Name:
Street Address :
 
City:
State:
Zip Code:
Telephone Number :
Facsimile Number:
TRADE REFERENCE 4   
Company Name:
Street Address :
 
City:
State:
Zip Code:
Telephone Number :
Facsimile Number:
BANK REFERENCE   
Bank Name:
Mailing Address :
 
City:
State:
Zip Code:
Contact Name :
Account Number:
Telephone Number:
 

For the purpose of obtaining merchandise from CASWAY on credit, this application authorizes CASWAY to contact any references given and inquire of them about applicant's credit history. Upon submission of this application, the applicant hereby certifies that the above information is true and correct. In addition to the foregoing, the applicant promises to pay for all purchases in accordance with CASWAY'S terms of sale.

 

Home | Email Us

Copyright © 1997 - 2008 Casway Distributors LLC

P. O. Box 370123 West Hartford, CT 06137
Office: 11 Palmer Drive, West Hartford, CT 06117
Warehouse: 87 Church St. East Hartford, CT 06108

Site Designed and Hosted by
Scullywag Site Design and Hosting