Application for Net 30 terms

Company Name

Billing Address

Address

City

State / Province / Region

Zipcode

Country

Shipping Address

Address

City

State / Province / Region

Zipcode

Country

Contact

Phone

Website URL

Tax ID

DUNS Number

Accounts Payable Contact

Full Name

Phone

Email for Invoice Submittal

Purchasing Contact

Full Name

Email

Tax Exempt

No

If you are tax exempt, please send signed exemption certificates to AR@classicautomation.com

Trade Reference

Company Name

Address

City

State / Province / Region

Zipcode

Country

Phone

Form Completed By

Full Name

Email

Notes/Comments

Email Company Credit Sheets to AR@classicautomation.com

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