Customer Credit Application

Customer Application

Please complete this application to establish a customer account with Viking Fence. All required fields must be submitted for review.
Sales Manager Email
example@vikingfence.com
How would you like to provide your company information?
Attach W-9 IRS Document

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Do you have a resale card?
Attach Resale Card (if applicable)

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Do you have a tax exempt certificate?
Attach Tax Exempt Certificate (if applicable)

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- Tax Identification Number
  Enter the FEIN for the company
- Type of Ownership
  Select the company's registration type
- Company Name
- Company Website
- Attention
- Contact Name
- Contact Title
- Contact Telephone
  Please enter a valid phone number.Format: (000) 000-0000.
- Contact Email
  example@example.com
- Is the business or billing address different than the W-9?
- Business Address
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip CodeCountry
- Billing Address (if different than above)
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Would you like to apply for a credit account with terms?
- Requested Credit Limit
- Select any applicable options
- Additional Comments
- Credit References (if applicable):
  
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- The undersigned affirms that the individual signing is duly authorized to execute this credit application and any related agreements on behalf of the applicant. By providing a signature, the signatory warrants and represents that they have full authority to bind the applicant and that all information provided herein is true, correct, and complete to the best of their knowledge. The applicant acknowledges that the credit grantor may rely upon this authorization and may request, obtain, and use consumer or commercial credit reports and references in connection with the establishment and maintenance of the account, subject to applicable law.
- Requestee Name
  
  First NameLast Name
- Requestee Title
- Requestee Email
  example@example.com
- Requestee Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Requestee Signature
- Should be Empty:

Customer Application