BASS TOOL CREDIT INFORMATION SHEET

To open an account, please complete the following information and submit.

COMPANY NAME:
BILL TO:
CITY:	STATE:ZIP
SHIP TO:
CITY:	STATE:ZIP
PHONE#:	FAX#:NO. OF YEARS IN BUSINESS:
Name of Owner/President:
Purchasing Agent:
Email address:
	REFERENCES - PLEASE LIST AT LEAST 2 TOOL SUPPLIERS!
NAME:
ADDRESS:
CITY:	STATE:ZIP
PHONE#:	FAX#:

NAME:
ADDRESS:
CITY:	STATE:ZIP
PHONE#:	FAX#:

NAME:
ADDRESS:
CITY:	STATE:ZIP
PHONE#:	FAX#:

Would you like a salesperson to contact you?:
Comments:
If you prefer to submit your credit application via fax or mail, please click HERE to print a copy.