NAGWorld - CREDIT APPLICATION

This Credit Application Will be Kept Confidential and Used Exclusively by NAGWorld Inc.

COMPANY INFORMATION

Owner's Name* *

Address

Apt, suite, etc.

Country

City

State

Zip code

Tel

Fax

ACCOUNTS PAYABLE INFORMATION

Accounts Payable Contact Person

Actual Payment Terms (transport). Please identify your terms:

BANK INFORMATION

Bank

Since

Account #

Branch

Phone

Credit $ Amount Desired

SUPPLIER REFRENCES (Minimum 3)

SUPPLIER #1

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone

Fax

SUPPLIER #2

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone

Fax

SUPPLIER #3

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone

Fax

SUPPLIER #4

Address

Apt, suite, etc.

Country

City

State

Zip code

Phone

Fax

REFERENCES

We authorize NagWorld Inc. to obtain credit references from our bank & suppliers. We understand and accept payment terms we have specified in the Accounts Payable section above

Name(s), Address(s), Email(s), Phone Number(s)

Authorized Person's Name

Authorized Person's Title

Date

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