__Proprietorship __Partnership __Professional
Corporation in the
State/Province of____________________________
Year of
Incorporation________________________________________
Full Name of
Business________________________________________
Address____________________________________________________
___________________________________________________________
Telephone______________________
Fax____________________
E-mail_________________________
Website________________
Registered/head
offfice_______________________________________
Telephone______________________
Fax___________________
E-mail_________________________
Web__________________
Number of years in business______ Annual
Sales___________
Bank__________________________
Branch________________
Trade References (Name, Address,
Telephone)
1.
________________________________________________________
2.
________________________________________________________
3.
________________________________________________________
The above
information is herewith Signed_________________
submitted for the purpose of
opening
an account and I do hereby certify this
Position________________
information to be
true.
Date___________________
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