Metro Reprographics - Your Digital Imaging Specialist

KIP America

Canon


PLEASE FILL OUT COMPLETELY AND SIGN TO ESTABLISH NET 30 DAY TERMS
Desired Credit Limit
COMPANY NAME:
d/b/a:
Bill to Address
Street Address
City/State
Owners(s)/President
Accts. Payable Contact
AP Phone & Fax #
AP E-mail Address
Banking Institution
Acct. Numbers
Contact
Phone & Fax #'s
Years in Business
Dunn & Bradstreet #
Annual Sales
Net Worth
Number of Employees
Federal Tax ID #
Please attach reseller's certificate
Company Structure	Sole Proprietorship Corporation State Partnership LLC
T R A D E R E F E R E N C E S
NAME OF COMPANY:
CONTACT:
CITY STATE
PHONE:

NAME OF COMPANY:
CONTACT:
CITY STATE
PHONE:

NAME OF COMPANY:
CONTACT:
CITY STATE
PHONE:
I authorize the release of the above information to Metro Reprographics for credit purposes only. In order for Metro Reprographics to grant me credit, I give permission for my credit to be checked as required for that purpose. Credit terms are net thirty (30) days from the date of invoice. Interest will be charged at 1.5% per month on items over thirty (30) days. If my account is referred for collection, I agree to pay all billing and collection costs and a reasonable attorney's fee. All the above is true and terms are accepted.
Print Officer's Name
Officer's Signature
Officer's Title
Date	Friday, November 21, 2008