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CREDIT APPLICATION Thank you for your interest in S. Walter Packaging Corp. In order to extend credit to you, we would like to make sure that we have all the necessary information. Please complete this form. All fields must be filled out completely in order to process your application correctly and quickly. Customer Account #__________________ Salesperson____________________ Company Name: Owner/Officers: Billing Street Address: Shipping Address: E-Mail Billing Preferred: Yes No E-Mail Billing Address: Billing Telephone #: Billing Contact Name: Years in business: Years at this location: Partial Shipments Accepted: Yes No Backorders Accepted: Yes D-U-N-S #: _ _ - _ _ _ - _ _ _ _ REFERENCES Supplier: Supplier: Address: Phone #: Fax #: Supplier: Address: Phone #: Fax #: Supplier: Address: Phone #: Fax #: Supplier: Address: Phone #: Fax #: Bank: Address: Phone #: Fax #: Address: Phone #: Fax #: No NEW CUSTOMERS Pending receipt of this information we suggest advance payment on the first order to expedite prompt shipment. Upon receipt we shall immediately process your order for production or shipment. CURRENT FINANCIAL INFORMATION Financial statements will be of great assistance to us in establishing a credit limit for you. Please email or fax any pertinent financial statements to S. Walter Packaging Corp. with the completed and signed application. TAX EXEMPT If applicable, please supply us with a copy of your Sales and Use Tax Certificate of Exemption form. DISCLAIMER We certify that all of the information on this form is correct. We fully understand that S. Walter Packaging Corp. terms are Net 30 days FOB. We agree to pay accordingly if credit is extended. ________________________________ Signature ________________________________ ___________________________ Name Title ___________ Date Email to: [email protected] or Fax to: 215-698-7119