Your On Line Credit Application
New England Steamway ® 128 East Street Wallingford, CT 06492 Tel: 1-800-322-5321/1-203-269-8412 Fax: 1-203-269-0162 email: newenglandsteamway.com
Fill in the areas required then when complete click on Submit. If you have any problems and would rather download a copy, fill it out the copy and either fax or mail it.
Go to Credit Application to download a copy for printing and mailing New England Steamway appreciates the opportunity to supply you with our products. In order to avoid delays in shipments or the need to send products C.O.D., New England Steamway will extend credit terms of net 30 days to qualified customers. If you wish to open a 30 Day Account, simply fill out this form , supply the information requested, click the submit button and your all done. Our credit department will notify you immediately when your credit has been accepted. Until approval is received, all purchases must be paid by cash, C.O.D., Visa, Discovery or MasterCard. Shipments made C.O.D. to you are not an inconvenience to us, we are just offering an alternate method of payment that may be more convenient for you. COMPANY INFORMATION: Company Name:
Date: Street Address:
City: State: Zip Code: Phone Number: Type of Business:
Fed ID Number: Year Company Established:
Tax Exemption Certificate:
Resale Number (Please Furnish Copy of Certificate):
OWNER (S)/OFFICER (S) INFORMATION: Check one:<CORPORATION> <PARTNERSHIP> <PROPRIETORSHIP> Name:
Social Security Number: Street:
City: State: Zip:
Home Phone: Name:
Social Security Number: Street: City: State: Zip:
Home Phone:
Years Under Current Management: TRADE REFERENCES (COMPANIES THAT EXTEND YOU NET TERMS): Company Name:
Account Number: Street:
Phone: Company Name:
Phone: Company Name: Account Number: Street: City: State: Zip:
Phone: BANK REFERENCE: Bank Name:
Account Name:
Street Address:
Account Number: City:
State: Zip: Contact: Phone Number: APPLICANT MUST READ AND SIGN I hereby certify that I am duly authorized to make this application and allow verification of the above information. I guarantee payment of all bills when due, and acknowledge a delinquency assessment at the maximum allowable interest rate by law until paid. In the event the account is placed with an attorney for collection or suit of the same is collected through probate or bankruptcy proceedings, then an additional reasonable amount shall be added to the same as attorneys fees. It is understood and agreed that any checks returned to us by your bank shall be charged a service fee. Any account with an Insuffient Funds check shall be placed on a C.O.D. cash only basis for a probationary period to be determined by the Credit Department. This guarantee shall be continuing, absolute and unconditional and shall remain in full force and effect until written notice of its discontinuance is sent by certified mail or registered mail, return receipt requested and actually received by New England Steamway and until any and all indebtedness existing before receipt of such notice shall be paid in full. INSTRUCTIONS FOR PROCESSING THIS FORM: 1. Fill out form completely and click Submit. 2. If you have any questions, please call us toll free at 800-322-5321 New England Steamway 128 East Street Wallingford, CT 06492 Thank you for the opportunity to be of service.