Home      Company Profile      Security & Privacy      B&M Guarantee      Return & Exchange      Payment Information      Credit Application      Contact Us

Login to view expanded catalog Login Id: Password: Category: All Bracelet Earrings Necklace Pendant Ring

Credit Application   Basic Information Business Name: DBA: Address 1: Address 2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West virginia Wisconsin Wyoming Zip: Phone 1: ext Phone 2: ext Fax: Email Address: Business's Information Type of Business: Corporation Partnership Sole Proprietorship Tax ID Number: Buyer's Name: Account Payable Contact: JTB Rating: JTB ID Number: D&B Rating: D&B ID Number: Principle Source of Business: Retail Wholsale Manufacturing Other Credit Line Desired: Under 1,000 1,000-3,000 3,000-5,000 5,000-10,000 Above 10,000 If Desired Credit Line is above $10,000, please specify: Owner's Information Owner/Principal's Name: Owner's Social Security Number: Home Phone: Cell Phone: How Long Have You Been in Business? Have You Been in Business Less Than One (1) Year? If you answered yes to this question, please fill in the next 4 fields: Yes No Previous Employer Name: Previous Employer Phone: ext Previous Employer Contact: Previous Employer Contact Phone: ext Have You Done Business with US in the Past? If you answered yes to this question, please fill in the next 4 fields: Yes No Name You Operated Under: Address You Operated From: City You Operated In: State You Operated In: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West virginia Wisconsin Wyoming Bank Reference: Name: Address 1: Address 2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West virginia Wisconsin Wyoming Zip: Account Number: Phone: ext Fax: Contact: Contact Phone: ext Trade Reference 1: Name: Address 1: Address 2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West virginia Wisconsin Wyoming Zip: Account Number: Phone: ext Fax: Contact: Contact Phone: ext Trade Reference 2: Name: Address 1: Address 2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West virginia Wisconsin Wyoming Zip: Account Number: Phone: ext Fax: Contact: Contact Phone: ext Trade Reference 3: Name: Address 1: Address 2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West virginia Wisconsin Wyoming Zip: Account Number: Phone: ext Fax: Contact: Contact Phone: ext Trade Reference 4: Name: Address 1: Address 2: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West virginia Wisconsin Wyoming Zip: Account Number: Phone: ext Fax: Contact: Contact Phone: ext The undersigned hereby makes this application for credit to B&M Imports Inbo.c (Creditor), and applicant agrees that all amounts payable on or before the due date as shown on each invoice will be paid, and if not paid on or before said date, are then delinquent. It is understood that Creditor may impose and charge a delinquency charge which is the lower of 2% per month or the highest rate allowed by law. Additionally, undersigned shall be responsible for all collection costs and attorney's fees in connection with any delinquent amounts. The laws of the state of New York shall be applicable to all suits arising under any agreement between the undersigned and Creditor. In the event of litigation, venue shall be in New York, NY. Certified mail will be sufficient notice to effectuate personal service over the defendant, and the defendant agrees to waive citation. Undersigned agrees creditor may apply payments at Creditor's discretion. Persons sign application certify all information is true and correct to the best of their knowledge and belief. This Formed Filled Out By (your name):    Title:

Copyright 2005 B&M Imports. All Right Reserved.