<<Click Here>> for a downloadable version (pdf) Credit Application (Online Version) Please complete the credit application form below to apply for a new account: Company Name* Enter 'Company Name' Trade Name Invalid Input Address* Enter 'Address' City* Enter 'City - Address' State* Please SelectALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Enter 'State' Zip Code* Enter 'Zip Code' Phone* Enter 'Phone Number' Fax Invalid Fax # Website Invalid Input --- Accounts Payable Contact Information --- Contact Name* Enter 'Accounts Payable Contact Name' Contact Phone* Enter 'Accounts Payable Contact Phone #' Contact Email* Enter 'Accounts Payable Contact Email' Contact Address* Enter 'Accounts Payable Contact Address' Contact City* Enter 'Payable Accounts Contact City' Contact State* Please SelectALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Enter 'Account Payable Contact State' Contact Zip Code* Enter 'Account Payable Contact Zip Code' --- Business Information --- Business Entity* Please SelectCorporationPartnershipIndividual Enter 'Business Entity' Fed ID # (SSN for Individual)* Enter 'Federal ID # or SSN' Type of Business* Enter 'Type of Business' Est. Annual Print Purchases ($)* Enter 'Approximate Annual Sales' Is the Company Tax Exempt?* Please SelectNoYes Enter 'Tax Exempt Status' Applicable Sales Tax Rate (%)* Enter 'Sales Tax Rate' County* Enter 'County' --- Business Banking Information --- Bank Name* Enter 'Bank Name' Account Number* Enter 'Bank Account Number' Bank Officer Name* Enter 'Bank Officer Name' Bank Phone Number* Enter 'Bank Phone Number' --- Trade References (3 required) --- Reference 1 Name* Enter 'Trade Reference 1 Name' Reference 1 Address* Enter 'Trade Reference 1 Address' Reference 1 City* Enter 'Reference 1 City' Reference 1 State* Please SelectALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Enter 'Reference 1 State' Reference 1 Zip Code* Enter 'Reference 1 Zip Code' Reference 1 Phone* Enter 'Reference 1 Phone Number' Reference 1 Fax Invalid Fax # --------------------------------------------------------------------------------------------------------- Reference 2 Name* Enter 'Trade Reference 2 Name' Reference 2 Address* Enter 'Trade Reference 2 Address' Reference 2 City* Enter 'Reference 2 City' Reference 2 State* Please SelectALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Enter 'Reference 2 State' Reference 2 Zip Code* Enter 'Reference 2 Zip Code' Reference 2 Phone* Enter 'Reference 2 Phone Number' Reference 2 Fax Invalid Fax # --------------------------------------------------------------------------------------------------------- Reference 3 Name* Enter 'Trade Reference 3 Name' Reference 3 Address* Enter 'Trade Reference 3 Address' Reference 3 City* Enter 'Reference 3 City' Reference 3 State* Please SelectALAKAZARCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Enter 'Reference 3 State' Reference 3 Zip Code* Enter 'Reference 3 Zip Code' Reference 3 Phone* Enter 'Reference 3 Phone Number' Reference 3 Fax Invalid Fax # --- Credit Terms & Conditions --- For the purpose of establishing and maintaining credit, the statements and information provided in and with this application are full, true, and correct. Applicant authorizes Absolute Color to make inquiry into, to request, and to receive any information concerning character, general reputation, financial or credit status from creditors or financial institutions which Absolute Color deems relevant for the granting and collection of the proposed indebtedness and the Applicant authorizes any creditor or financial institution to divulge such information. Applicant understands that Absolute Color will rely on the accuracy of any information set forth in and with this application and all information obtained in determining whether to extend credit. Applicant agrees to pay all charges within 30 days from invoice date. Applicant understands and agrees that payment in accordance with agreed upon terms is not contingent on Applicant’s receipt of payment from any other party for goods or services provided by Absolute Color. Applicant agrees to pay all costs of collection, including reasonable attorney fees, in the event Applicant fails to pay any charges when due. Absolute Color reserves the right to not extend credit to the Applicant or to withdraw credit at any time at Absolute Color’s sole discretion. Applicant wishes to apply for credit with Absolute Color in accordance with these terms and conditions which have been read, understood and accepted. The undersigned is an officer or owner of Applicant and is authorized to represent and bind Applicant with respect to these matters. Agree to Terms?* Yes, I agree Agree to Credit Terms and Conditions Electronic Signature (Type Name)* Enter 'Electronic Signature (Type Name)' JobTitle* Enter 'Job Title' Please Select* Invalid Input