MERRICK TACKLE
477
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POLICY PAGES
Merrick Tackle Center Inc.
NEW ACCOUNT FORM & CREDIT APPLICATION
For U.S.A. Accounts Only
This application must be filled out completely in order to open an account.
PART I
Please complete the following and return by mail or fax.
Date:________________
Credit applications are not processed until an order is placed.
You may submit your order with this application to open your account.
Please check one:
1. Applicant is a:
corporation
partnership
sole proprietorship
a. If a corporation, it is incorporated in the State
a.
of_________________________________
b. If a corporation, the name of the President
b.
is_________________________________
c. If a partnership or sole proprietorship the owner(s)
c.
must complete the following:
Name(s)
Home Address
Social Security Number
__________________________________________________________________ ______________________
__________________________________________________________________ ______________________
2. Applicant operates under the trade name(s) of:_______________________________________________________
3. The firm operates at the following location(s):
Address
Phone Number
Cell Number
Fax Number
_____________________________________________________________________________________________
_____________________________________________________________________________________________
4. Mailing address if different from shipping address:___________________________________________________
Email:______________________________
Website:____________________________ What percentage of your business is internet?_____% mail order?_____%
5. The main office is located at:____________________________________________
6. Date the firm began business:__________________
7. Business bank name and location:
Name of your Bank:___________________________________Account #___________________
Address___________________________________ City______________________State_______
Person to Contact:__________________________ Phone:________________________
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