Corporate Account Application FormA-Power Admin2019-12-20T14:43:20-08:00 Corporate Account Net Terms Credit Application Form Account InformationDo you have an existing account?* Yes No Please log in first to upgrade your current account to a corporate account. Log InUsername* Password* Enter Password Confirm Password Business InformationLegal Business Name* DBA / Operating as Date Business Established* MM slash DD slash YYYY Business Type* Corporation Organization Partnership Proprietorship Require PO# on Orders* Yes No Phone Number*Fax NumberAddress* Street Address Address Line 2 City Province Postal Code Purchaser / Owner InformationFull Name* First Last Title* Phone Number*Email* Address* Street Address Address Line 2 City Province Postal Code Accounts Payable ContactFull Name* First Last Title Phone Number*Email* Address Street Address Address Line 2 City Province Postal Code Bank InformationBank Name Location / Branch Phone NumberFax NumberContact Name First Last Shipping Address (Primary)Name* First Last Phone Number*Fax NumberAddress* Street Address Address Line 2 City Province Postal Code Credit Amount RequestedAmount*Sales RepresentativeName First Last AuthorizationWe the undersigned authorize A-Power Computer Ltd to contact the references listed above for the purpose of establishing credit. We also authorize the references listed to disclose all detail necessary to enable A-Power Computer Ltd to establish an account for Net 30 purposes. We further certify that the information provided herein and in conjunction with this application is true and correct. We understand that A-Power Computer Ltd. Will retain this agreement regardless of whether an open account is established and should an open account be established. We agree that all invoices shall be paid 30 days from invoice date. All information received shall be treated confidentially by A-Power Computer Ltd and will be used only for establishing credit.Full Name* First Last Title* Date* MM slash DD slash YYYY Trade ReferencesNumber of References* 2 3 4 Reference #1Name* First Last Phone Number*Fax NumberAddress* Street Address Address Line 2 City Province Postal Code Reference #2Name* First Last Phone Number*Fax NumberAddress* Street Address Address Line 2 City Province Postal Code Reference #3Name First Last Phone NumberFax NumberAddress Street Address Address Line 2 City Province Postal Code Reference #4Name First Last Phone NumberFax NumberAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country NotesCAPTCHA
