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New Customer Account / Application for Credit Form
Complete information must be provided for application to be considered
Company name and addresses
Company Principals
Authorized Purchasing Agents
Company Type:  
Preferred Payment Term:  
Invoice/Statement Method:  
Sign up for new products email:
 
Sign up for specials/news email:
 
Are you a Stens Customer:
 		  
Please provide four references that the company has charge accounts with
 
I hereby certify that the information in this credit application is correct, and I agree to the terms and conditions stated in Arrowhead Electrical Products’ catalogs, price sheets, and other company publications, as they may pertain to ongoing credit transactions. I also understand that my / our account is payable within 30 days of the invoice date, and that any account over 30 days old will be subject to C.O.D. terms without notice. A standard service charge of 1 1/2% per month will be levied on all open balances 30 days past due. Such charges will continue each month thereafter until the account is paid. Any legal and / or collection fees required to secure payment on this account will become my / our responsibility. The completion of this form does not necessarily guarantee open account privileges. I also authorize the above trade and bank references to release the information necessary to make a sound credit decision.
 
Preferred Shipper:
Freight Forwarder:
Code as seen below
 
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