Bob Johnson's Computer Stuff - Company Account Application

Thanks for taking the time to fill out a company Account Credit Application. This application is for appling for credit or the use of company checks with Apex Corp. of NJ. Do not hit the submit button. At the moment it does not work correctly. Therefore just Type in the necessary information below, Print it out and fax it to (908) 791-0717. Don't forget to sign at the bottom of the form.

**Company Account Credit Application**
Company Name:
Address1:	Address2:
City:	State:	Zip Code:
Country:
Telephone Number: --	Fax Number: --

Organization Format:
Sole Proprietor	Partnership
Corporation	Other -

Years in Business: years - months	# of Employees	Annual Sales

Officers, Partners, Owners, or Other Responsible Parties
Name:	Title:
Home Address:
City:	State:	Zip:
Telephone Number: --	SS#: --

Name:	Title:
Home Address:
City:	State:	Zip:
Telephone Number: --	SS#: --

Name:	Title:
Home Address:
City:	State:	Zip:
Telephone Number: --	SS#: --

List 3 principal Suppliers with whom you have maintained credit with for a min. of one year
Supplier #1:
Supplier Name:
City:	State:	Zip:
Acct #:	Contact Person:
Telephone Number: --

Supplier #2:
Supplier Name:
City:	State:	Zip:
Acct#:	Contact Person:
Telephone Number: --

Supplier #3:
Supplier Name:
City:	State:	Zip:
Acct#:	Contact Person:
Telephone Number: --

Bank Information:
Bank Name:	Contact:
Address:	City:
	Zip Code:
Telephone Number: --	Fax Number: --
Checking Acct. #:	Savings Acct#:

I/We hereby agree to the terms unless otherwise agreed to in writing. In the event of collection, the customer pays all costs and attorney fees.

Signature: _____________________________	Date: ______________________

Signature: _____________________________	Date: ______________________