Southwest Business Machines, Inc.

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Southwest Business Machines, Inc.
564 23rd Avenue East
Dickinson, ND 58601
(701) 225-3213 or (800) 767-3582

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Office Supplies

In Partnership with
Crest Capital Equipment Leasing

Application for Commercial Charge Account

Desired Line of Credit: $ Email:
Date: Company Name:
Street Address: Phone #:
City: State: Zip: Fax:
Type of Business: No. of Years Established:
Corporation Co. Partnership Limited Partnership Individual Proprietor

Important Tax Information

4.0% 5.0% 5.5% 6.0% 6.5% Tax Exempt (Other:) Tax ID#:
If a Branch Office or a Division - give name of Parent Company or Home Office		Mailing Address for Accounts Payable Statements:

Principle Owners - Partners - Officers of the Company
Name:	Mailing Address:	City:	State:	Zip:

Persons Authorized by your Company to make Purchases
	List All Authorized Persons:

Trade References
Names:		Addresses:

Bank References
Bank Name:	Bank Official:	City:	State:	Zip:
Credit Terms: Net 30 days from invoice date. A 1.5% delinquency charge will be assessed on all outstanding balances not paid within terms. I hereby accept the within stated credit terms and authorize SBM, Inc. to inquire on the above listed trade and bank references. CREDIT AND RETURN POLICY: No returns will be accepted after 30 days from date of invoice. All cash and charged purchases returned for credit MUST be accompanied by original invoice. 20% restock fee on all "SPECIAL ORDERS" or "NON-STOCK" items returned for credit. Some "SPECIAL ORDERS" may not be able to be returned. Prepaid outbound freight will also be deducted from the credit amount. I have read and agree to the above Terms and approve this application:
Authorized Applicant Name:

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