DURHAM METAL SERVICES
1445 HOPKINS STREET,
WHITBY, ONTARIO, L1N 2C2
Tel: (905) 666-0045 Fax: (905) 666-0027

APPLICATION FOR CREDIT PRIVILEGES

Fill out and fax to (905)666-0027
LEGAL COMPANY NAME:  
Address



 
Contact:  
Email Address  
Phone  
Nature of Business:  
Fax:  
Yearly Steel Purchases:  $
Credit Limit Required:  $
Circle Company Type   Proprietorship    Partnership    Limited Corporation
PST License:  
Please supply Certificate of Exemption if Applicable.
GST No.:  
Bank:  
Contact & Phone:  
Address  
Account Number:  
TRADE REFERENCES:  Company Name/Phone Number/Contact
1)  
2)  
3)  

Ownership Information:

  Name Address Position
1.      
2.      
3.      
CONSENT:
I/We consent to the obtaining of information as required from time to time in connection with credit applied
for or any renewal or extension thereof, and to the disclosure of information to any credit reporting agency
by any person, company, or financial institution with whom the undersigned has dealings.

Signature: ___________________________________________
Date:____________________________________


Office Use Only:
References Checked: ______________
Credit Approved: _______________________________________________
Limit: $ ___________________________
Terms: _______________________
Date: _____________________