Account Application — SDS Camp Supply

Part 1 — Billing & Owner Information

Bill To

Corp Name *

Address

City

State

Zip Code

Business Type

Corporation Partnership

Telephone *

Cell

Fax

Owner

Title

Address

City

State

Zip

Home Telephone

Social Security

Part 2 — Shipping & Additional Owner

Ship To

Trade Name

Address

City

State

Zip

Business Type

Additional Owner (if applicable)

Title

Address

City

State

Zip

Home Telephone

Social Security

Bank Reference

Bank Name & Details

Bank Name

Address

City

State

Zip

Phone Number

Fax Number

Type of Account

Account Number

Business Trade References

Reference 1

Company Name

Address

City

State

Zip

Phone

Fax

Type of Account

Terms

Add a Second Reference

Reference 2

Company Name

Address

City

State

Zip

Phone

Fax

Type of Account

Terms

Add a Third Reference

Reference 3

Company Name

Address

City

State

Zip

Phone

Fax

Type of Account

Terms

Delivery Requirements & Specifications

Please review dating on all products at time of delivery. Any concerns must be addressed at time of delivery. Minimum dating is 4 months. Please fax completed form to 718-861-7643.

Main Contact Email Address *

Used for billing, receiving, and promotional communications.

Delivery Setup

Delivery Appointments Necessary?

Yes No

Loading Dock?

Yes No

Lift Gate Required?

Yes No

Pallet Jack Available for Inside Truck?

Yes No

Forklift Available?

Yes No

Forklift Unload? (Do You Go Into Truck and Unload?)

Yes No

Trailer Accessible?

Yes No

Driver Needs to Bring to Back of Trailer? (May result in surcharge depending on zone)

Yes No

Trailer Size Limitations?

Yes No

If Yes, Please State Limitations:

Pallets May Be Shipped Sideways — Any Issues Removing Them?

Yes No

Hours & Scheduling

Receiving Times & Cut-Offs

Open Saturdays?

Yes No

Open Sundays?

Yes No

Additional Notes

Agreement & Submission

All invoices are to be paid within the credit terms allotted by Sultana Distribution Services from the date of invoice. Delinquent accounts will be placed on a COD basis.
By submitting this application, you authorize Sultana Distribution Services to make inquiries into your banking and business history, and to answer questions about your payment experience with us.
Sultana Distribution Services does not participate in fees for credit references. Any fee charges will be the responsibility of the applicant and will not be reimbursed.

Authorized Signature

Title *

Name *

Date *

Wholesale Account Application

Customer Credit Application

Application Submitted!