Hillman Brass and Copper, Inc.
Confidential Credit Application

2345 Maryland Road  P.O. Box 'R'  Willow Grove, PA 19090

Please print and complete this application and fax a signed copy to 215-659-0807
Firm Name  
Type of Business  
Bill To Address  

 
Phone Number  
Fax  
Accounts Payable Manager  
Owner or Officers  

 
Name/address of bank  
Business Structure q Corporation in ________________ (State)  q Partnership  q Individual
Date Firm Started  
Trade References (3 required)

Please give only names from whom you purchase an open account with "NET 30 DAY" terms and a similar dollar volume. Please include at least two from outside your own state.

 Company Fax Phone
     
     
     
The preceding information is true to the best of my knowledge. I/we understand that the terms of sale are NET 30 DAYS unless otherwise noted. A 1 1/2% finance charge per month will be assessed against invoices not paid within these terms.
Date  
Authorized Signature  
Title  

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