Credit Application « Pinto's Plumbing & Heating Supply, Inc.

Please fill out what is required. If you have bank and trades on separate form, you may upload them at the bottom of this page.
Company Name *as it appears in the Articles of Incorporation
Trade Names if different from above. *
Company's Physical Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Company's Billing Address
If different from above.Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone Number and Fax Number
Email Address
Website
Ownership
Individual/Proprietorship, PartnershipLLC, LLPCorporation
Federal ID# *
License #
Date Business Started
Sales Tax Status
Please attach Tax Exempt Certificate, if applicableTaxableNon-Taxable
1st) TRADE REFERENCE NAME
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Business Phone - Fax Number Contact Name/Phone and Fax
2ND) TRADE REFERENCE NAME
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone and Fax Number
3rd) TRADE REFERENCE NAME
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Business Contact Name,Phone and Fax
BANK REFERENCE NAME
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone and Fax Number
Tax Exempt Certificate Upload