New Customer Credit Application
By submitting this form, you are certifying the information you provide is true and correct to the best of your knowledge and accept the terms stated below:

Payment Terms: For approved credit accounts, terms of payment are net 30 days from date of invoice unless otherwise agreed upon in writing. All other sales are COD. Seller does not accept credit or debit cards. Failure to make payment when due constitutes a default. On any past due invoice, Seller may impose interest at a rate of 1.5% per month until such amounts are paid in full. In the event of default, Buyer shall be liable to Seller for its cost, fees, expenses, including, but not limited to: attorneys fees, court costs and fees, and collection costs.

Architectural Surfaces llc
405 E Main St Chattanooga, TN 37408 | 423.899.6233 |
Full Legal Name *
Your answer
Street Address *
Your answer
Billing Address (if different from above)
Your answer
AP Contact
Please provide phone number and email
Your answer
Other Contacts
Please provide names, phone numbers, and email address of other relevant contacts
Your answer
Bank Reference *
Please provide bank name including the name, phone, and email of bank representative.
Your answer
Trade Reference *
Please provide at least 2 trade references, including business name and contact information
Your answer
Are you sale tax exempt *
If yes, certificate must be on file at time of invoicing. Please email exemption certificate to
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service