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APPLICATION FOR CREDIT OUR PAYMENT TERMS

ARE NET 30 DAYS
Complete Name of
Your Business:

Full Address:
City State Zip Code
Telephone Number : ( ) Approx. Number of Employees:
FAX Number: ( )

Check One: Corporation L.L.C. Partnership Personal
Names of Title:
Principals: Title:

Building: Owned Leased Date Started
Type of Business:
EXAMPLE: Injection Molders, Extruders, Blow Molders, Die Makers, Distributors, etc.
Types of Equipment:
EXAMPLE: Injection Molding Machines, Extruders, Mills, Lathes, etc.
Complete Name of Your Bank:
Address:

Accounts Payable Contact:
Name: E-mail:
Telephone Number : ( ) FAX Number: ( )

Please List Five Business References below: (Please include phone and fax telephone numbers)

Name Complete Address City State Zip Code

Phone/FAX Numbers Your Account Number
Name Complete Address City State Zip Code

Phone/FAX Numbers Your Account Number
Name Complete Address City State Zip Code

Phone/FAX Numbers Your Account Number
Name Complete Address City State Zip Code

Phone/FAX Numbers Your Account Number
Name Complete Address City State Zip Code

Phone/FAX Numbers Your Account Number
By: Date form completed:
Signature
The above information will provide us with a basis for granting credit. You have our
assurance that all credit information is held in the strictest of confidence.
Please Print Name
RETURN THIS WITH YOUR TAX EXEMPT FORM.

© Copyright 2021 Plastic Process Equipment, Inc.
PLASTIC PROCESS EQUIPMENT, INC.
8303 CORPORATE PARK DRIVE, MACEDONIA, OHIO 44056-2300
216-367-7000 • Fax: 216-367-7022 • Order Fax: 800-223-8305
Toll Free USA, Canada & Mexico: 800-362-0706
PPE www.ppe.com • sales@ppe.com
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