Customer Application

Ownership Name/DBA Name

Phone number

Individual proprietor/Corp Officer

Cell number

Billings Address

Shipping Address

Purchasing Agent

Cell number

Date

Fax

Accnt Payable Contact

Cell number

Is Business Incorporated??

Yes

Select one:

Corp

Inc

LLC

Length:

Give us a few reference

Company Name

Address

Clerk/Phone #

I hereby certify that the information contained herein this application is completed and accurate. I hereby authorize the financial institutions listed in the application to release necessary information to the company for which is being applied for to verify the information contained herein. All News Accounts Will Ship COD cash until credit is approved, we agree to pay according to the terms and conditions as stated by Best Buyer Site LLC.If we fail to do so, then we agree to pay any late charges, reasonable collections cost and attorney fees if account is placed under collection.

Applicant's Name/Title

Signature/Date

Applicant's Name/Title

Signature/Date

For Best Buyer Site LLC Use Only:

Sales Rep Name Signature/Date

Remarks:

Officer's Signature/Date

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