credit app form

You may fill out this form and submit it online, or print it out (click somewhere in this frame and then use your browser's print functions) and send it to us at:

ART-PHYL CREATIONS, 16250 NW 48 AVE, MIAMI FL 33014, ATT: FINANCE

TO AVOID DELAY COMPLETE IN FULL.
All information will be held in strict confidence

BILL TO:

NAME

COMPANY

ADDRESS

ADDRESS

CITY, STATE, ZIP

COUNTRY

PHONE, FAX

EMAIL

SHIP TO: (If other than Bill To)

NAME

COMPANY

ADDRESS

ADDRESS

CITY, STATE, ZIP

COUNTRY

PHONE, FAX

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GENERAL BUSINESS INFORMATION

YEARS IN BUSINESS,                              YEAR OF INC.,     STATE OF INC.

OFFICERS' NAMES                                  TITLE

ARE YOU SALES and/or USE TAX EXEMPT? YES NO
CERTICATE NUMBER:

ACCOUNTS PAYABLE CONTACT - NAME, PHONE, EXT:

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BANK REFERENCE

BANK NAME

ADDRESS

ADDRESS

CITY, STATE, ZIP

COUNTRY

PHONE, FAX

OFFICER HANDLING

CHECKING ACCOUNT NUMBER

SAVINGS ACCOUNT NUMBER

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BUSINESS REFERENCES (Minimum of three)

NAME

ADDRESS

CITY, STATE, ZIP

PHONE, FAX

ACCOUNT NUMBER

NAME

ADDRESS

CITY, STATE, ZIP

PHONE, FAX

ACCOUNT NUMBER

NAME

ADDRESS

CITY, STATE, ZIP

PHONE, FAX

ACCOUNT NUMBER

Thank You. If you have submitted online you will receive an email confirmation that we have received your application. Please allow 2-3 weeks for processing.