TEXTON Account & Credit Application

Contact Information
What Type of Business are You?*
Company Name*
Name*
First Last
Email*
Website
Phone*
Fax
Cell Phone
Address & Location
Company Physical Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Company Billing Address (If Different)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Tax ID
Company Tax ID#*
Type of Delivery Location*
- Commercial
- Residential
Payment Type
How would you like to pay?*
- Pre-Pay
- COD
End of C.O.D. Information.
If you are not applying for Net 30 Terms with TEXTON, please scroll to the bottom of the page and press "Submit".

Net 30 Term Accounts
To apply for a Net 30 Term account with Texton, Inc. please provide the additional information below. Allow 2-4 weeks for terms to be established.
Are You a Corporation?
- Yes
- No
Years in Business?
Accounts Payable Name
First Last
Email
I prefer to receive invoices by:
- Email
- Fax
- Regular Mail
Owner Information
Name
First Last
Driver License #
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Partner Information
Name
First Last
Driver License #
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone

Bank Reference
Name of Bank
Bank Phone
Bank Fax
Bank Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Checking Account #
Bank Officer First Name
Bank Officer Last Name
Trade Reference 1
Name
Phone
Fax
Email
Account #
Trade Reference 2
Name
Phone
Fax
Email
Account #
Trade Reference 3
Name
Phone
Fax
Email
Account #
Trade Reference 4
Name
Phone
Fax
Email
Account #
Trade Reference 5
Name
Phone
Fax
Email
Account #

Account & Credit Application