I am a new customer
I already have an account and would like to update or change my payment options
Company Name
Account/Customer Number
Residential
Commercial
Mobile
Product Categories (Select all that apply)
True49 Representative
or Sales Person
Company Name
General Business Details
Doing Business As (DBA)
Structure of Business
Select One
LTD.
INC.
Proprietorship
Partnership
Address
City
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Alberta
British Columbia
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Postal Code
Rental Property
Own/Purchased Property
Lease Expires
Use this as my Ship-to Address
Phone
Fax
Date Business Started
PST #:
GST #:
EHF #
(Environmental Handling Fees) If left blank, EHF fee will be charged on each applicable invoice.
Ship-to Address
Address
City
Province
Select province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Business Owner(s) Information
Name
Title
Phone
Name
Title
Phone
Accounting & Ordering Details
Accounts Payable
Contact Name
Email
Ordering/Payment Information
Credit Request Amount
$
Will Accept First Order C.O.D.
Yes
No
Method of Payment
Select One
Electronic Transfer
Credit Card
Cheque
Floorplan
Business Bank Information
Branch Name
Contact Name
Account Number
Phone
Floorplan Details
Provider
Select One
Mega
GE Commercial Finance
Cantrex
Member Number
Trade References
1
Company Name
Email
Floorplan
Open
Terms
Contact Name
Phone
Fax Number
2
Company Name
Email
Floorplan
Open
Terms
Contact Name
Phone
Fax Number
3
Company Name
Email
Floorplan
Open
Terms
Contact Name
Phone
Fax Number
Credit Card Authorization
Step 1
DOWNLOAD
Right Click/Save Target As...
Download, complete in pen/ink, and sign the Credit Card Authorization Form.
Step 2
Scan and upload the completed form.
I Agree
True49 Technologies Ltd. covenants that the credit card information issued above is strictly confidential to the establishment and maintenance of the credit account applied for herein. The credit card holder being the undersigned of this application form, covenants by the execution of their signature authorization for True49 Technologies Ltd. to obtain monies due pursuant to the card holders agreement they have established with the above credit granter.
Credit Policy
I / We the undersigned agree to pay the account within terms stipulated on each invoice. I / We the undersigned hereby authorize True49 Technologies Ltd. or its agents to obtain such credit reports or other information as may be deemed necessary in connection with the establishment and maintenance of an account or for any other direct business reason. If any account becomes in arrears and a collection process becomes necessary, all amounts on the account become immediately due and payable and terms no longer apply. At this time all shipments to the under- signed will be halted pending resolution of this matter. True49 Technologies Ltd. reserves the right to revoke signed will be halted pending resolution of this matter. True49 Technologies Ltd. reserves the right to revoke your terms of credit as indicated above and agree to abide by them.
I, the applicant for this Credit Application, warrant the truthfulness of the information provided in this application.
Digital Signature
Your Email
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
Please type your First and Last Name