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Apply for Net 60 Terms

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New Pacific Direct, Inc.

7411 Central Avenue, Suite B, Newark, CA 94560
Tel: (510) 818.9388 Fax: (510) 818.9389 E-mail: info@newpacificdirect.com
CREDIT INFORMATION FORM
* Company Name
* Phone
Fax
* Address
* City
* State
* Zip Code
* E-mail
Web
Subsidiary of or DBA
* Federal Tax I.D.
Resale No.
D&B #
* Type of ownership:  
* No. of Years in Business
Annual sales Turnover
No. of Location
No. of Employees
* Name(s) of Principal Owner(s)
* SSN is required if not incorporated
BANK INFORMATION
* Name of Bank
* Account No.
* Phone
* Address
* City
* State
* Zip Code
REFERENCES
(Firms currently extending credit terms)
Name
Address(City,State,Zip Code)
Phone
Fax

*
 We hereby certify that the above information is true. We authorize the above trade and bank references to release information to New Pacific Direct, Inc. to be used explicitly for the establishment of an account and credit line. This information is to be kept strictly confidential.

In the event New Pacific Direct, Inc. must refer any undisputed amount overdue to outside collection agency or attorney, we agree to pay all reasonable collection costs, including but not limited to attorney fees, court costs, sheriff's cost, and collection fees incurred by New Pacific Direct, Inc. We understand that New Pacific Direct, Inc. Terms of Sales are net 60 days and a service charge of 1.5% per month is added to any amount overdue. We agree to these terms if credit is extended.


* Signature
* Date
* Title