Credit Application – Alice Peterson Company

In order to open an account with Alice Peterson Company, you must complete this credit application. You will need a copy of the following documents:

Your current business license
Your wholesale/tax certificate

This application will take approximately 10-20 minutes to complete. Once complete, it will be transmitted to our new accounts department, via a secure connection, for processing. We will be in contact with you shortly thereafter.

Complete the Form Below

Step 1 of 7

14%

Company Name*
Address
Street Address Address Line 2 City State ZIP Code
Type of Business*
Please select all that apply. To make multiple selections, hold the "CTRL" key and click the options with your mouse.

Is this company a Subsidiary of a Parent Company?
- Yes
- No
Parent Company Name*
Parent Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Contact
Office Manager
First Last
Office Manger Email
Phone
Fax

Billing Contact Information
Is the Billing Contact the same as the Office Manager?
- Yes
- No
Billing Contact Person
First Last
Billing Contact Email
Billing Contact Phone
Billing Contact Fax

Business Licensing & Tax Information
Federal Tax ID (EIN)*
Business License
Drop files here or
Please upload a current copy of your business license.
Resale Certificate
Drop files here or
Please upload a copy of your resale certificate.

Industry References
Please provide a minimum of three (3) industry references. You may add up to five (5) references here.
Industry Reference
Company Name
Account Number
Contact Person
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Untitled

Whereas, I as a business owner as well as individually personally referred to as "Purchaser", guarantee payment of all purchases made by "Purchaser" or any indebtedness incurred by "Purchaser"; Orders are to be paid in full credit by credit card ONLY. "Purchaser" must provide Credit Card information including expiration date and 3-digit security code on all orders; Purchaser" also agrees to the shipping, return and payment policies as they are explained under the whole policy located at our customer service page.
Certification*
- I have read and agree to these terms
Signature*

Complete the Form Below

Step 1 of 7

Primary Contact

Billing Contact Information

Business Licensing & Tax Information

Industry References

Login