Cordeck Application For Credit

Company Name(Required)

Name of Firm or Individual

Billing Contact(Required)

First Last

Billing Email(Required)

[email protected]

Billing Phone Number(Required)

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Is your billing address DIFFERENT than your physical address?(Required)

Yes

No

Physical Address(Required)

Street Address Address Line 2 City State ZIP Code

Additional Contact Information

Purchasing Name

First Last

Purchasing Email

Purchasing Phone

Sales Name

First Last

Sales Email

Sales Phone

Marketing Name

First Last

Marketing Email

Marketing Phone

Are you Tax Exempt and/or for Resale?(Required)

Yes

No

Please upload a copy of your Tax Certificate(Required)

Accepted file types: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif, Max. file size: 100 MB.

Would you like to apply for credit terms?(Required)

Yes

No

Credit Application Form

We request your cooperation in completing and returning this form to us as soon as possible so that we can review your request for credit availability.

Federal ID #(Required)

Number of Years Established(Required)

Number of Years at current Address(Required)

Ownership Type(Required)

Corporation

Partnership

Individual

Sole Proprietorship

Government

Date of Incorporation(Required)

State of Incorporation(Required)

Type of Business or SIC #(Required)

How many Principal Owners?(Required)

Principals Information

Principal 1 Name(Required)

First Last

Principal 1 Title(Required)

Principal 1 Email(Required)

Principal 1 Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Principal 1 Phone Number(Required)

Principal 2 Name(Required)

First Last

Principal 2 Title(Required)

Principal 2 Email(Required)

Principal 2 Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Principal 2 Phone Number(Required)

Principal 3 Name(Required)

First Last

Principal 3 Title(Required)

Principal 3 Email(Required)

Principal 3 Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Principal 3 Phone Number(Required)

Name of Bank(Required)

Account Number(Required)

Account Contact Name

First Last

Address of Bank(Required)

Street Address Address Line 2 City State ZIP Code

Bank Contact Email(Required)

Bank Contact Phone Number(Required)

Bank Fax Number(Required)

Trade References

Company 1 Name(Required)

Company 1 Address(Required)

Street Address Address Line 2 City State ZIP Code

Company 1 Phone Number(Required)

Company 1 Email

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Company 2 Name(Required)

Company 2 Address

Street Address Address Line 2 City State ZIP Code

Company 2 Phone Number(Required)

Company 2 Email(Required)

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Company 3 Name(Required)

Company 3 Address

Street Address Address Line 2 City State ZIP Code

Company 3 Phone Number(Required)

Company 3 Email(Required)

Billing Information

Account Payable Contact Name(Required)

First Last

Account Payable Contact Phone Number(Required)

Account Payable Email(Required)

Terms & Conditions

Signature(Required)

Your Title(Required)

Today's Date(Required)

A signed copy of this document, electronically transmitted, shall be binding and shall be deemed an original for all purposes.

Cordeck Application For Credit

Customer Form

We request that all new customers complete the form; if you decide you’d like to apply for credit, that option is available below.

Additional Contact Information

Credit Application Form

Principals Information

Trade References

Section Break

Section Break

Billing Information

Terms & Conditions

What Our Customers Say About Us!

“I just wanted to say thank you for expediting my order. We got the decking at 6:30 this morning and my customer was thrilled. Your customer service is outstanding. I appreciate it and look forward to working together again.”

– Jordan Nass, Precision Building Solutions