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Credit Application

Download a copy of Matrix Video's Credit Application ( PDF 65 KB).

Legal Business Name:	*
Other Trade Name:	*
GST#:
PST#:
GST or PST Exemption #: (If applicable)

Mailing Address:
Principal Address:
City:
Province:
Postal Code:
Telephone:
Fax:

SHIPPING ADDRESS (If different):
Shipping Address:
City:
Province:
Postal Code:

Principal(s) / Officer(s):
1. First / Last Name:
Title / Position:
Home Address:
Telephone:

2. First / Last Name:
Title / Position:
Home Address:
Telephone:

3. First / Last Name:
Title / Position:
Home Address:
Telephone:

Business Information:
Year Business Started:	(YY)
Year Present Ownership Started, if different:	(YY)
Type of Business:	Corporation Partnership Proprietor Other:
Line of Business:	Manufactures Wholesales Retails Other:
Total Employees:
Insurance Coverage ($CAD):
Owns Promises:	Owns Promises
Rent's Promises:	Rent's Promises
Size od Premises (Sq. Ft.):
Total Annual Sales ($CAD):
Accounts Payable Contact Name:
Phone / Fax:
Email Address:	*
Accountant Firm Name:
Accountant:
Phone:

Bank Reference:
Name of Bank:
Account#:
Contact:
Address:
City:
Province:
Phone:

Trade References:(Minimum 3)
1. Company Name:
Address:
Phone:
Fax:

2. Company Name:
Address:
Phone:
Fax:

3. Company Name:
Address:
Phone:
Fax:

Mailing Address: