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Credit Application Form-FM

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FM GLOBAL LOGISTICS (PHIL.), INC.

2nd Floor TMI Centre Bldg Arzobispo St. Intramuros Manila


Tel. Nos.: 527-0221/527-0224/ 567-3261/567-3272 Fax No.: 527-0209

CUSTOMER CREDIT APPLICATION FORM


Business Name: Company Web Site:

Address:

Nature of Business:

Name of Contact/s:

Tel: Mobile No. Email: Fax:

Corporation: Partnership: Sole Proprietorship:

SEC/DTI Registration Number: Date Issued:


Authorized Capital: REQUIRED DOCUMENTS:
_____ Company Profile
Subscribed Capital: _____ DTI Registration Certificate
_____ SEC Registration Certificate
Paid-Up Capital: _____ Articles of Incorporation
_____ TIN/VAT Registration
Number of Employees: _____ Mayor's Permit
_____ Audited Financial Statement for the last 2 years - BIR Received Copy

COMPANY OFFICERS

CEO : VP Finance/Accountant:

President: General Manager:

Managing Director: Purchaser:

TRADE REFERENCE (SUPPLIER)

Suppliers Contact Person Contact Number Term

BANK REFERENCE

Terms & Conditions

Terms and conditions shall be confirmed by authorized officers of both parties and be given only after complete documentation and credit investigation.

I certify that all information provided above are true and correct. I hereby authorized FM GLOBAL LOGISTICS (PHIL.), INC. to perform the necessary
investigation on the above information.

Signature: _________________________________________________ Date: __________________________________________________

Name: __________________________

Position: _________________________

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