PO Box 288 Florida, NY 10921 888.333.2260 www.3c4g.com www.stylebybliss.com
NEW BUSINESS VERIFICATION FORM Thank you for your recent order. We want to make sure that we have the correct information in our system. To ensure accuracy, we would like to verify your account information. Please complete the form below and fax it to (877) 324-3377. We will make sure that your account is set up correctly and your orders will get processed without any problems. If you have any questions, please contact Customer Service at (888) 333-2260.
GENERAL INFORMATION BUSINESS NAME:
SHIP TO:
Street Address:
Street Address:
City, State, Zip:
City, State, Zip:
Phone:
Buyer:
Fax:
Email:
ACCOUNTS PAYABLE INFO Contact Name:
Tax ID:
A/P Phone:
NY & MD Resale #:
A/P Fax:
A/P Email:
TYPE OF BUSINESS Toy Store
Gift Store
ECommerce
Pharmacy
Aquarium
Zoo
Educational Supply
Other
Other: How long under current ownership?
How did you hear of us?
Would you like a Sales Rep to call on you? Yes
No
Do you have a current Catalog? Yes
No
PRINCIPLE INFORMATION Principle Name(s):
Phone:
Address:
Fax:
City, State, Zip:
Email:
BUSINESS TYPE:
C Corporation
S Corporation
Partnership
Sole Proprietor
LLC
PAYMENT INFORMATION Please charge (check one):
Select One:
This order only.
Visa
This order and all future orders.
Mastercard
Applying for terms (complete credit app)
American Express
Discover
Card Number: Expiration Date:
SCC#:
Name on Card:
I hereby certify that all merchandise purchased from CNR Products Inc. will be purchased for resale in the regular course of business. I hereby authorize CNR Products Inc. to charge the above referenced credit card for the related transaction. I agree to all terms and conditions set forth by CNR Products Inc.
SIGNATURE:
TITLE:
DATE:
PO Box 288 Florida, NY 10921 888.333.2260 www.3c4g.com www.stylebybliss.com
CREDIT APPLICATION All orders are Prepay until credit is approved. Prepay by credit card or check for the full amount of the order (plus freight) to release the order immediately. Please allow 2-4 weeks for shipping on orders applying for net terms.
GENERAL INFORMATION BUSINESS NAME:
SHIP TO:
Street Address:
Street Address:
City, State, Zip:
City, State, Zip:
Phone:
Buyer:
Fax:
Email:
APPLICANT’S BANKING INFORMATION Bank Name:
Branch:
Address:
Address:
City, State, Zip:
City, State, Zip:
Phone:
Fax:
Checking Account:
Contact Person: Savings Account:
TRADE REFERENCES (do not list prepaid, COD or suppliers with less than 1 year purchasing experience)
Company Name:
Company Name:
Address:
Address:
City, State, Zip:
City, State, Zip:
Phone:
Fax:
Phone:
Acct#:
Acct#:
Company Name:
Company Name:
Address:
Address:
City, State, Zip:
City, State, Zip:
Phone: Acct#:
Fax:
Phone:
Fax:
Fax:
Acct#:
I hereby certify that all merchandise purchased from CNR Products Inc. will be purchased for resale in the regular course of business. Additionally, I hereby authorize the references listed above to divulge any pertinent information regarding the credit status of this business to CNR Products Inc. I understand that all information is held in the strictest of confidence and used solely for credit consideration purposes. I agree to all terms and conditions set forth by CNR Products Inc.
SIGNATURE:
TITLE:
DATE: