Builders Hardware and Hollow Metal Inc.

"The door people"

W165 N5690 Continental Parkway, Menomonee Falls, WI 53051
262-781-5525  Fax 262-781-4232

Credit Application
Print this form out.

   The following information is required for open-account consideration.  Please PRINT OR TYPE.

Name of Company:___________________________________________________

_{___________________________________________________________________________
Street Address                                                        City                                        State            Zip}                    

_{(___)__________________                (____)_______________       _______________________
                Phone Number                                                Fax Number                        Line Of Business}

_{Billing Address:_______________________________________________________________}

_{Credit Limit Desired: $____________________     Circle:  Corporation      Partnership      Individual}

_{If partnership, name of partners:___________________________________________________}

_{Name & Title of corporate officers:_________________________________________________}

_{___________________________________________________________________________}

_{Number of years in business:_________  Taxable: YES___ NO___ Tax Exempt #______________}

_{Current Trade References: (List at least 4 Material Suppliers)}

_{1) Company Name:____________________________________________________________}

_{__________________________________________________________________________
Street Address                                                                City                               State            Zip}

_{(____)___________________(____)_____________________________________________
Phone                                                Fax                                            Accnt#}

_{2) Company Name:____________________________________________________________}

_{__________________________________________________________________________
Street Address                                                                City                               State            Zip}

_{(____)___________________(____)_____________________________________________
Phone                                                Fax                                            Accnt#}

_{3) Company Name:____________________________________________________________}

_{__________________________________________________________________________
Street Address                                                                City                               State            Zip}

_{(____)___________________(____)_____________________________________________
Phone                                                Fax                                            Accnt#}

_{4) Company Name:____________________________________________________________}

_{__________________________________________________________________________
Street Address                                                                City                               State            Zip}

_{(____)___________________(____)_____________________________________________
Phone                                                Fax                                            Accnt#}

_{This application acknowledges the right to inquire and agrees to our terms of net 30 days, 1% finance charges on balances over 60 days. CREDIT HOLD instituted on all custom hollow metal purchases aging over 30 days. If suit or action by an attorney is instituted, reasonable attorney fees will be the responsibility of applicant.  Tax Exempt Certification must be on file before ordering.}

_________________________________________________________________
AUTHORIZED SIGNATURE/ TITLE & DATE

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