Gateway Metals, Inc.                                             CREDIT APPLICATION

9550 Watson Industrial Park
Crestwood, MO 63126
Phone: 314-918-1111 or 800-229-7842
Fax: 314-918-1213

Company Name:_________________________________________________________

Telephone Number:_____________________     Fax Number:____________________

 

Bill To Address:                                                Ship To Address:

 

_______________________________              _______________________________

 

_______________________________              _______________________________

 

_______________________________              _______________________________

 

Business Style (check one)   Corporation______   Partnership______   Individual_____

 

Year Business Started_______________     Requested Credit Limit_________________

 

Listed in Dunn & Bradstreet:   No_____   Yes_____    D&B Number________________

 

Tax Exempt:   No______   Yes______   If Yes, please Fax exemption certificate.

Person to contact about past due accounts:  ____________________________________

Do you prefer invoices to be (circle one): Mailed or e-mailed to   ________________________ or Faxed

Gateway Metals payment terms are 1% 10 Net 30.

Any credit that is extended is subject to perfection of lien. In the event an account must be turned over to collections, customer will be responsible for any collection and attorney fees incurred.

BANK REFERENCE

Name of Bank:____________________________ Acct. Number:____________________

Type of Acct.: Checking ______ Savings ______ Business ______

Contact:_____________________________  Phone Number:_______________________

Address:__________________________________________________________________

Accounts Requesting $5,000 or more credit, please attach a recent balance sheet.

TRADE REFERENCES

_______________________________  _____________________  ___________________

                                Name                                                       Phone #                                   Fax #

 

_______________________________  _____________________  ___________________

                        Name                                                       Phone #                                   Fax #

 

_______________________________  _____________________  ___________________

                        Name                                                       Phone #                                   Fax #

 

I affirm that each of the answers given to the foregoing questions are true and correct and authorize anyone mentioned to furnish such information as you may require in connection with this application.

 

Customer Signature (required)________________________________________________

 

Title:_________________________________________   Date:______________________