New Account Form
Today’s Date
02/23/2012
Submitted by
Business Name (d.b.a)
Store #
Address
City, State
Tel
Fax
Store Contact Person
Email
A/P Contact
Mailing Address
Same as above
Tel number
Starting service date
Distributor
Cash
Charge
COD
Reference
Business Name
Tel
Address
Contact
Banking
Bank name
City
Acct #
Tel Number
We agree in having a net 14, and to comply with Casa Sanchez Foods payments terms in consideration in receiving credit terms.
Signed
Title
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Type the Word
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