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Rex Credit Application
Full Legal Names: (*)
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Trade Style (if used):
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Owner(s) Name(s)
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Street Address (*)
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City (*)
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State/province (*)
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Zip/postal Code
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Country (*)
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Email (*)
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Telephone Number (*)
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Fax Number (*)
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billing Address (if Different)
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Person(s) Responsible For Payment
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Number Of Years In Business (*)
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Number Of Employees
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Estimated Purchase Requirement
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Subsidiary/division/affiliation
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Tax/GST/HST/Fed Id. No. (*)
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Are Transformers for Resale, own use or other? Provide Details (*)
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Credit Limit Desired
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Payment Pattern
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YourBankingInformation (*)
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name & Branch Location Address
Major Supplier #1
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Name&Phone
MajorSupplier #2
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Name&Phone
MajorSupplier #3
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Name&Phone
I/We therefore permit Rex Power Magnetics to further verify this information to their current standards.
I/We the undersigned, herby certify that the above information about the said organization is correct.