Credit Application 1

Name: Howard Precision Metals Inc.
Address: 8058 North 87th Street, Milwaukee, WI, 53224
Telephone: (414)-355-2637
Price range: $$

Date*
MM slash DD slash YYYY
Amount of credit requested*
NOTE: FORM MUST BE FILLED IN COMPLETELY AND ACCURATELY FOR HOWARD PRECISION METALS, INC. TO CONSIDER OPENING A CREDIT ACCOUNT.
GENERAL INFORMATION
Company Name*
Phone No.*
Fax No.
E-MAIL Invoices ?*
- Yes
- No
Email address*
BILLING ADDRESS*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
SHIPPING ADDRESS*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
A/P CONTACT*
PURCHASING CONTACT*
BUSINESS ACTIVITY*
DATE ESTABLISHED*
MM slash DD slash YYYY
WISCONSIN TAX STATUS*
- TAX EXEMPT
- NOT TAX EXEMPT
- CERTIFICATE ENCLOSED (IF EXEMPT)
ORGANIZATION
OWNERSHIP*
- PROPRIETORSHIP
- PARTNERSHIP
- CORPORATION
CORPORATE OFFICER: PRESIDENT*
NAME OF PARENT COMPANY, IF SUBSIDIARY
BANK REFERENCE
NAME OF BANK*
CONTACT*
Address*
Street Address Address Line 2 City State / Province / Region
Phone*
TRADE REFERENCES
REFERENCE 1
NAME
CITY
STATE
ZIP
Phone
Fax
REFERENCE 2
NAME
CITY
STATE
ZIP
Phone
Fax
REFERENCE 3
NAME
CITY
STATE
ZIP
Phone
Fax
REFERENCE 4
NAME
CITY
STATE
ZIP
Phone
Fax
PAYMENT TERMS: ½ OF 1% - 10 DAYS: NET 30 DAYS FROM INVOICE DATE.
THE UNDERSIGN CERTIFIES THAT THE INFORMATION ON THIS FORM IS CORRECT AND THAT HE/SHE FULLY UNDERSTANDS HOWARD PRECISION METALS CREDIT TERMS AND AGREES TO PAY WITHIN THOSE TERMS IN CONSIDERATION OF EXTENDED CREDIT. ALL INFORMATION WILL BE KEPT CONFIDENTIAL.
Authorized Signature*
Title*
Date*
MM slash DD slash YYYY

GENERAL INFORMATION