One Stop Shopping for Loading Dock Equipment
     N90 W14507 Commerce Drive   Menomonee Falls, WI 53051 
Phone: 262-502-1707  Fax: 262-502-1762 .
e-mail:info@multi-fab.com   www.multi-fab.com


Credit Application Form
Date:  Complete Legal Name:
Street Address:
City: State or Prov.: Zip or Postal Code:
Country: Phone #: Fax #:
Description of Business:   
Year Bus. Started: Year Bus. Inc: Annual Sales $:
Bank Reference: Account No.:
Business Structure
Trade References: ALL four references must be filled in with current open account creditors that allow your firm to purchase $1,000.00 or more, within the last 12 months. * Required
Firm Name #1:
Contact:
Phone:* 
Fax:*
Address:
City:
State/Prov/Country:
Zip:
       
Firm Name #2:
Contact:
 		Phone:*
 		Fax:*
Address:
City:
State/Prov/Country:
Zip:
       
Firm Name #3:
Contact:
 		Phone:* 
Fax:*
Address:
City:
State/Prov/Country:
Zip:
       
Firm Name #4:
Contact:
 		Phone:* 
Fax:*
Address:
City:
State/Prov/Country:
Zip:
** Please send via U.S.P.S. or Fax 1 copies of your State Exempt/Resale certificate**.
Company Principals Responsible for Business Transactions.
Name
Title
Since
Mailing Address
c/o ownership:
c/o ownership:
c/o ownership:

Applicant Name:

Title: Date:
Email Address:   

Additional Information to assist us in your request:

© Copyright 2007 by Multi-Fab Products, LLC and Web Centers of America, Inc.