PAS New Dealer Credit Application


DEALER CREDIT APPLICATION

You can download the credit application in Adobe Acrobat PDF format and mail or fax to us. Or you can fill out the form below. Please complete all areas accurately and completely. Upon submission PAS will contact you with further instructions. For additional information or if you have any questions email sales@pas-toc.com or call (760) 431-9924.

Download credit application.

Date:

Company Name:

Telephone:

Email:

Shipping Address:

City:

State:

Zip:

Billing Address:

City:

State:

Zip:

How long in operation?

Type of Business:

List name, position and home address of principles of company:

1. Name:

Address:

City:

State:

Zip:

2. Name:

Address:

City:

State:

Zip:

Are purchase orders required?

Are back orders accepted ?

Name of Bank:

Account #:

Address:

City:

State:

Zip:

Phone:

Fax:

List four (4) business references:

1. Name:	City:	State:
Phone:
Fax:
Account #:

2. Name:	City:	State:
Phone:
Fax:
Account #:

3. Name:	City:	State:
Phone:
Fax:
Account #:

4. Name:	City:	State:
Phone:
Fax:
Account #:

All personally identifiable information collected on the PAS web site is used solely by Professional Audio Systems, Inc. Personal information will not be posted or published by us, nor will it be provided to third parties without prior written consent.