Allen Reproduction Co., Inc.

Open a line of credit account with Allen Reproduction for all of your printing needs. Please complete this form in it's entirety:

Billing Information

Company Name:

Company E-mail Address:

Shipping Address

Street 1:

Street 2:

City:

State:
(ie: NJ, PA, DE)

Zip:

Phone:

Attention To:

Billing Address

Street 1:

Street 2:

City:

State:
(ie: NJ, PA, DE)

Zip:

Phone:

Fax:

Accounts Payable Contact:	Accounts Payable Phone:

Check here if tax exempt:

Tax Exempt Number:

Reasons for Service

Check all that apply:

	Purchasing bid sets of blueprint	Supplies / AIA Forms
	General printing services	Paper Sales

TRADE REFERENCES List three vendors that you regularly pay on invoice (do not list banks or credit card companies):

Business Name	Contact Name	Address, City, State	Phone Number

Miscellaneous Information

Has your company (subsidiaries, parent co., etc.) or current officers filed for bankruptcy in the last seven years? Check if Yes:

If there are any special needs, or requirements for your payable department, please list them below and we will try to accomodate them, if possible.

What is the highest credit limit you desire?

Does your company require a purchase order number on all orders? Check if Yes:

Credit Policy

Payment Terms: Net 30 days from the date of order with the approved credit. Without approved credit a personal or corporate credit card is required.
Invoicing Statement: The original invoice will be mailed after the order is completed. A statement will be issued if there is an outstanding balance at the end of the month. A 1.5% finance charge will be added for any past due balance and a $40.00 service charge will be assessed for any returned check.
Payments: Please return the remittance stub or copy of invoice with your check to the mailing address on the invoice or statement.
NOTE: Please be advised that if payments are not received within terms, you will be subject to having all future orders held and your line of credit removed. Any and all costs involved in the collection of delinquent accounts (attorney fees, court costs, collection agencies, etc.) will be the sole responsibility of the debtor.

In consideration of the extending credit, I authorize Allen Reproduction Co., Inc. to contact the above suppliers for credit information. The undersigned hereby authorizes Allen Reproduction Co., Inc. to obtain copies of consumer reports. I understand that in obtaining such consumer reports, a consumer reporting agency may be used, and I do hereby authorize such use. I guarantee all payments within the agreed terms.

Signature
First Name:	Last Name:	Email Address:

I agree to to terms and conditions of this credit policy.

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