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Bel Air Online Credit Application Form

	Company Information
Legal Company Name :
Company Address :
City :
Province :
Postal Code :
E-mail address :
How Long :
Estimated Annual Sales :
Sales Area :
Business Type :	Incorporated Partnership DBA
GST# :
Phone# :
Fax# :
Is a financial statement available :	Yes No
Amount of credit requested :
	Owners, Principals and Officers - 1
Name :
Title :
Address :
Phone :
SIN# :
	Owners, Principals and Officers - 2
Name :
Title :
Address :
Phone :
SIN# :
	Owners, Principals and Officers - 3
Name :
Title :
Address :
Phone :
SIN# :
	Trade References - 1
Name :
Title :
Address :
Phone :
Contact :
	Trade References - 2
Name :
Title :
Address :
Phone :
Contact :
	Trade References - 3
Name :
Title :
Address :
Phone :
Contact :
	Trade References - 4
Name :
Title :
Address :
Phone :
Contact :
	Bank References
Bank :
Address :
Phone :
Banker Name :
Account type :	Incorporated Chequing Loan
Acct.# :
Comments :

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Company Information