SIGNIN
SIGNUP
Email Address:
Password:
CREATE AN ACCOUNT
GAMETEK SHOP
Call us now:
+1702.685.7613
CREDIT APPLICATION
Kindly fill all required fields at the previous page and the check the email address are proper or not.
General Details
Company Name
Billing Address
Shipping Address
Business Type
Years Operating
Business Structure
Corporation
Partnership
Sole Proprietorship
Duns #
Is this company A Subsidiary or Division of A Parent Company?
yes
No
If Yes, Please List Name & Address
Relationship
Division
Subsidiary
Wholly Owned
Owners, Partners & Officers
Name (1)
Title (1)
Name (2)
Title (2)
Requested Credit Amount
Expected Monthly Orders
Tax Re-Sale Certificate Enclosed
yes
No (If No, Tax Must Be Charged)
Financial Details
Fiscal Year End:
MM:
DD :
YYYY :
Net Worth
Annual Sales
Profit/Loss
Your Bank is
Phone
Bank Address
Fax
Acc No (Checking)
Acc No (Savings)
Bank Officers Name
TRADE REFERENCES
Reference # 1 :
Name (1)
Address (1)
City (1)
State (1)
Zip Code (1)
Phone (1)
Fax (1)
Reference # 2 :
Name (2)
Address (2)
City (2)
State (2)
Zip Code (2)
Phone (2)
Fax (2)
Reference # 3 :
Name (3)
Address (3)
City (3)
State (3)
Zip Code (3)
Phone (3)
Fax (3)
I understand that the information contained in this application is to be used for the sole purpose of achieving credit terms from GameTek USA Inc.
Signature
Position
Date
MM:
DD :
YYYY :
previous
|
next
