Name of the company : __________________________________DBA : _______________________________________
Billing Address :____________________________________________________________________________________
Delivery Address : (if different)_________________________________________________________________________
Phone Number : __________________________________Fax Number : ________________________________________
Please circle appropriate one : Sole/Proprietor / Partnership / Corporation
Type of business :_____________________________________Date Established:________________________________
Owners of Officers : _________________________________Owners of Officers : ________________________________
Purchasing Agent :_________________________________Accounts Payable Contact :____________________________
Other Locations: ____________________________________________________________________________________
Purchase Orders Required : Yes / NO Purchase Taxable: Yes / No Number of Invoices Required_________________________
Special Instruction :__________________________________________________________________________________
Business Bank :_______________________________Checking Account Number:_________________________________
Branch Address: _______________________________________________Bank Phone :___________________________
Trade References :
Name :___________________________Address:_________________Phone:__________________Fax:________________
Name :___________________________Address:_________________Phone:__________________Fax:________________
Name :___________________________Address:_________________Phone:__________________Fax:________________
Name :___________________________Address:_________________Phone:__________________Fax:________________
I am aware of Sweetener Products terms and agree to pay all invoices within them.
Please consider this your authorization to release banking information on my account number:______________________
To sweetener Products Company for the Purpose of obtaining credit.
Date:____________________________Singed:_________________________________________Title:__________________
Complete and Fax To Sweetener Products Co. 323-232 0233