[Grimes Header]

CREDIT APPLICATION

Grimes Industrial Products Group
130 Rivalda Road, Toronto, Ontario M9M 2M8

Note: Many references refuse to provide credit information by phone. Providing a fax number, will expedite the credit check process.

 
Application Date:
 
Company Information
 
Reg. Name:
Trade Name:
Street Address:
City Address:
State/Province:
Zip/Postal Code:
Country:
 
Ship To Address (if different)
 
Ship To Name:
Ship To Address:
City/Province/PC:
Attention:
 
Telephone:
Facsimile:
E-mail:
Repeat E-mail:
 
Business Type:
Yr. In Business:
Credit Request:
Own or Rent:
Contact Name:
PST Number:
 
Bank Reference
 
Bank Name:
Bank Address:
City/Province/PC:
Bank Contact:
Bank Phone:
 
Business References
 
Ref. Name:
Ref. Phone:
Ref. Fax:
 
Ref. Name:
Ref. Phone:
Ref. Fax:
 
Ref. Name:
Ref. Phone:
Ref. Fax:
 
 
 
 
 
Profile History Quality Employment
Specials Directory Terms Site Map