Business Account Application

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WE MAKE IT OUR BUSINESS TO HELP YOUR BUSINESS

Email *

What type of account would best suit your business? *

Cash Account (all items will have to be paid for at time of purchase)

Charge Account (all items can be paid at time of purchase OR items can be paid at the end of the month)

YYYY

Complete Business Name *

Federal I.D./EIN *

Business Street Location *

Mailing Address *

City, State, Zip Code *

Phone Number *

-- Financial Information --

Credit Sources, Institution Name, Address

Special Billing Instructions (Including PO Requirements)

List Items to be Purchased (Does not have to be exact) *

List of Authorized Users (First & last names separated by commas) *

Sales Tax Status (If tax exempt, provide tax exempt form)

Exempt

Not Exempt

Clear selection

Tax Exempt Number (If applicable)

-- Owners, Officers, or Principals --

Full Name, Title, Address, Phone

I hereby certify that the information contained herein in complete and accurate. This information has been furnished with the understanding that it is used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize a consumer reporting agency chosen by Northwest Ace Hardware or the financial institutions listed in this credit application, to release necessary information (personal to business) for which credit is being applied, in order to verify the information contained herein. The cashier typing your name is consenting to your agreement to the terms above.

A copy of your responses will be emailed to the address you provided.

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