CABLE TIE WRAPS

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Credit Application

Click here to download our online credit application form (in pdf format).

Please fax this request to (450) 431–1183.

Online form

CREDIT APPLICATION

Company name :
Address :
City :
Province/State :
Postal/Zip code :
Telephone :
Fax :
Contact :
Title :
Email:

Bank References

Bank :
Address :
City :
Province/State :
Postal/Zip code :
Telephone :
Account N° :
Transit N° :

Supplier References

Name :
Address :
Telephone :
Contact :

Name :
Address :
Telephone :
Contact :

Name :
Address :
Telephone :
Contact :

By the present document, the undersigned authorizes Synergie V3 Inc. to obtain all the necessary information to conduct a credit investigation with references that are supplied to us. The undersigned certifies that all information on this form are correct.

Payments terms are net 30 days from invoice date. All the delivered products will remain the property of Synergie V3 Inc. until the final payment of the deliveries.

I have read this form and am in agreement with the terms mentioned above without any exception.