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Toll Free: 1.800.387.2840

Rex Credit Application Form
  1. By clicking the “submit” button below, you are agreeing to receive email communication from Rex Power Magnetics regarding your inquiry.
  2. Full Legal Names: (*)
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  3. Trade Style (if used):
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  4. Owner(s) Name(s)
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  5. Address (Street)(*)
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  6. City / Town(*)
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  7. State / Province(*)
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  8. Zip / Postal Code
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  9. Country(*)
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  10. Email(*)
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  11. Telephone Number(*)
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  12. Fax Number(*)
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  13. Billing Address (if Different)
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  14. Person(s) Responsible For Payment
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  15. Number Of Years In Business(*)
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  16. Number Of Employees
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  17. Estimated Purchase Requirement
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  18. Subsidiary/ Division/ Affiliation
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  19. Tax/GST/HST/Fed Id. No. (*)
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  20. Are Transformers for Resale, own use or other? Provide Details(*)
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  21. Credit Limit Desired
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  22. Payment Pattern
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  23. Banking Information (Institution, Branch, Adress)(*)
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  24. Major Supplier #1 (Name & Phone Number)
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  25. Major Supplier #2 (Name & Phone Number)
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  26. Major Supplier #3 (Name & Phone Number)
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  27. I/We therefore permit Rex Power Magnetics to further verify this information to their current standards.
  28. I/We the undersigned, herby certify that the above information about the said organization is correct.
  29. (*)

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  30.