To apply for credit, please fill out the application below. Click "I Agree" to send your request.
Company:
Address:
City:
Province:
Postal Code:
Tel:
Fax:
PST #:
GST #:
Type of Business:
Corporation
Partnership
Sole Proprietorship
Years in Business:
Partners or Corporate Officers
1. Name, Title, Phone:
2. Name, Title, Phone:
Bank Reference
Bank Name & Address:
Acct #:
Contact Name and Phone:
Trade References
1.
Tel:
2.
Tel:
3.
Tel:
Agreement
I certify that the above information is true and authorize Impact Auto Parts., verify the above credit Information.
I agree to pay all invoices within the credit terms indicated on the invoices. I agree to pay service charges of 1/2% per month on any past due invoices, and to pay any legal fees that have been incurred to recover past due accounts.
It is understood that all merchandise remains the property of Impact Auto Parts, until it is paid in full.
I acknowledge that I am personally liable for all unpaid invoices purchased from Impact Auto Parts Inc. under my own name, trade name or corporate name.
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