Luvicom | Credit application for a professional account

INFORMATION AND PROFESSIONAL COORDINATES

Company Name*

Phone*

Fax

Email*

Registered company address*

Street Address City Province Postal code Country

Type of company*

Individual company
Partnership
Capital company

Business start date*

Billing address*

Use the registered address of the company

Street Address City Province Postal code Country

Delivery address*

Use the registered address of the company

Street Address City Province Postal code Country

PROFESSIONAL AND BANKING INFORMATION

Main business address*

Use the registered address of the company

Street Address City Province Postal code Country

How long has it been at the current address?*

Phone*

Fax

Email*

Name of the bank*

Bank address*

Street Address City Province Postal code Country

Bank phone*

Type of account*

Savings account
Check account

Account number*

Comments

PROFESSIONAL / COMMERCIAL REFERENCES (SUPPLIERS)

Company Name*

Address*

Street Address City Province Postal code Country

Phone*

Fax

Email*

Company Name*

Address*

Street Address City Province Postal code Country

Phone*

Fax

Email*

Company Name*

Address*

Street Address City Province Postal code Country

Phone*

Fax

Email*

Agreement

1. All invoices must be paid 30 days after the invoice date.
2. Invoice claims must be made within seven business days.
3. By submitting this application, you authorize Luvicom Inc. to inquire about the banking and professional / commercial references you have provided.
4. By signing this credit application, you certify that all information provided is true and reflects reality.
5. The undersigned personally guarantees the sums due and refuses all rights of division and discussion.

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Credit application for a professional account

INFORMATION AND PROFESSIONAL COORDINATES

PROFESSIONAL AND BANKING INFORMATION

PROFESSIONAL / COMMERCIAL REFERENCES (SUPPLIERS)

Agreement

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