Credit Application Form – Marine Safety Equipment

Marine Safety Equipment Service & Sales Company Limited

Cor. Tucker Valley & Airways Roads,
Chaguaramas, Trinidad, W.I.

Tel: 1-868-634-4410,
Fax: 1-868-634-2067
info@marinesafetytt.com

Customer / Company Information

Name *

Company's Name

Trading Name (If different to above)

Street Address *

City

State/Province

Country

Phone Number *

Fax Number

Email Address *

Nature of Business *

Director / Partner Information

(1) Director / Partner Name *

(1) Director / Partner Contact Tel: *

(1) Director / Partner Email *

Director / Partner Information (2)

(2) Director / Partner Name *

(2) Director / Partner Contact Tel: *

(2) Director / Partner Email *

Accounts Payable Contact Information

A/P Contact Name *

A/P Contact Tel *

A/P Contact Email *

Alternative A/P Contact Name *

Alternative A/P Contact Tel *

Alternative A/P Contact Email *

Banking Information

Bankers *

Branch *

Contact Name *

Trade References

Please Note:

All accounts are COD until a credit application has been completed, reviewed, and approved.

Submission of this application form for review and possible approval only, submission does not constitute an automatic acceptance and applicant shall await approval before such is assumed.

Location

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