WBDS ONLINE CREDIT APPLICATION
 
 

Español
 
 

* Company Name

* Mail to Address

Mail to Address (continued)

* City

* State

* Zip

Ship to Address (Only if Different than Mail to Address)

Ship to Address (continued)

City

State
Zip

*Phone Number
Fax Number

*E-mail Address

* Business is owned
* Nature of Business
* Owner, Partner, Officer Name * Title




Credit References with whom you have established OPEN ACCOUNTS
* Company Name Fax Number * Phone Number












* Person Authorized * Title




Purchase Order Number Required YES NO Federal ID#
Taxable YES NO
(If no, please fax a copy of your Tax Certificate to 305-573-2410)

* Accounts Payable Contact

* Phone Number
Fax Number
BY SUBMITTING THIS APPLICATION YOU AGREE TO THE FOLLOWING:
Unpaid balances over 30 days from the invoice date will be assessed 1.5% interest per month. WBDS aggressively pursues collections of it's overdue accounts receivable. Any invoice(s) which requires legal assistance for collection will be subject to reasonable attorney's fees in addition to the above referenced interest.
* I agree

* Signature Name
* Title
* Date     Month/Day/Year
Comments