BAMBERGER MEXICO

APPLICATION FOR CREDIT

VERSION EN ESPAÑOL

All information contained in this application is sent trough a safety connection

 
To acelerate this porocess, don't forget to full fill all fields
Customer Identification
Are you already a BAMBERGER'S customer? NO YES      Date:

  
General Data
   
Name of Company
Address: street Number Int.

City P.C.

County  
 
TAX ID
 DUN'S Number
Phone
Long D. Code
Number
Extention
Fax Number
Long D. Code
Number
Extention
Country State
 
Company's Contact
 
Last Name
First Name
Position
Web Page

Página Web

Business Type

CORPORATION
LLC
SOLELY OWNED
 
Number of Employees
1 - 10
11 - 50
51 - 100
101 - 500
MORE THAN 500
Credit Line Requested
$
Activity
MANUFACTURER
RE-SELLER
 
Year in business
 
Line of Business

INJECTION
EXTRUTION
MOLDING
ROTO MOLDING
COEXTRUTION
BLOW MOLDING

 

Yearly Sales in Dollars

0 - 500,000
501,000 - 1'000,000
1'000,001 - 5'000,000
5'000,001 - 10'000,000
MORE THAN 10'000,000
 
Machinery
How Many Type
Other

Other

 
Terms of Credit Requested
0 days 30 days   45 days   60 days
Representatives
   
Powered of Attorney ( 1 ) TAX ID
Nationality
Phone
L.D. Code
Number
Ext.
 
Powered of Attorney( 2 ) TAX ID
Nationality
Phone
L.D. Code
Number
Ext.
 
Trade References from plastic industry
   
Company Name ( 1 ) Contact Name
Credit Garanted
$ 		Terms of Payment
days
Email
Phone
L.D. Code
Number
Ext.
 
Company Name ( 2 ) Contact Name
Credit Garanted
$ 		Terms of Payment
days
Email
Phone
L.D. Code
Number
Ext.
 
Company Name ( 3 ) Contact Name
Credit Garanted
$ 		Terms of Payment
days
Email
Phone
L.D. Code
Number
Ext.
 
Bank References
 
Bank Name ( 1 ) Other Contact Name
Kind of account Credit Garanted Amount Credit Garanted
$
Email
Phone
L.D. Code
Number
Ext.
 
Bank Name ( 2 ) Other Contact Name
Kind of account
 Credit Garanted Amount Credit Garanted
$
Email
Phone
L.D. Code
Number
Ext.
 
Bank Name ( 3 ) Other Contact Name
Kind of account
 Credit Garanted Amount Credit Garanted
$
Email
Phone
L.D. Code
Number
Ext.
 
   



     
 



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