Credit Application

Credit Application
TICMS, Inc is in receipt of an order from your company to perform calibration services and/or sell instrumentation. Our records show that we don’t have current credit information on your company. Would you please take a few minutes and provide the information requested below so that we may process your request without delay?
Company Name
Contact Person
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Federal I.D. Number / Tax Number
Principals Name
Year Business Opened

Bank Reference
Bank Name
Account #
Contact Payment Person
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date Account Opened
Email

Trade References
1 - Company Name
Contact Person
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax
Email
2 - Company Name
Contact Person
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax
Email
3 - Company Name
Contact Person
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax
Email

Credit Card Information
Name of the Cardholder
Credit Card #
Expiration Date
CVV Code
Credit Card Billing Address
(Where the credit card statement is sent to.)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax