Welcome | Become a Dealer

Apex Business Systems is a wholesale manufacturer of business forms. Therefore, we can only sell to those who resell our products. Should you have any questions regarding your qualifications, please call our Credit Department at the toll-free number listed below.

Please complete the following profile in DETAIL to ensure a prompt response from our Credit Department. If preferred we can fax you a credit application that can be completed and returned to Apex via fax or mail. To request a faxed or emailed credit application call our Credit Department at 1-800-354-2739, or fax request to 1-800-600-2739, or email your request to our Credit Department. For questions concerning the completion of this profile please call 1-800-354-2739 and ask for the Credit Manager.

Apex Business Systems appreciates your business!

Billing Information

Company*:
Contact Person*:
Title:
Street Address 1*:
Street Address 2:
Mailing Address 1:
Mailing Address 2:
City*:
State/Province*:
Country*:
Zip/Postal Code*:
Email Address*:
Phone Number*:
Sales Tax ID*:

Other dealer information or shipping instructions:

General Information

Business Type*:
State of Incorporation*:
Principal 1*:		Title 1*:
Principal 2:		Title 2:
Principal 3:		Title 3:
Home Office*:
Address*:
Year Established:		If new, prior form sales experience? Yes No
With what firm?
Where:
Number of Salesmen:
Number of Employees:
Listed with Dunn & Bradstreet?:	Yes No
Amount of Credit Line Requested*:

References

Bank 1*:
Bank 1 Address*:
Bank 1 Phone*:
Bank 1 Fax:
Bank 2:
Bank 2 Address:
Bank 2 Phone:
Bank 2 Fax:

Supplier 1:
Supplier 1 Address:
Supplier 1 Phone:
Supplier 1 Fax:
Supplier 2:
Supplier 2 Address:
Supplier 2 Phone:
Supplier 2 Fax:
Supplier 3:
Supplier 3 Address:
Supplier 3 Phone:
Supplier 3 Fax:

Certification & Authorization to Release Information

I hereby certify that the information in this Customer Profile is correct. The information in this Customer Profile is for the use of Apex Business Systems in determining the amount & conditions of credit to be extended. I understand that the company may also utilize other sources of credit information considered reliable in making this determination. Further, I hereby authorize the bank & supplier references listed in the Customer Profile to release the information necessary to assist in establishing a line of credit & further agree to pay any reasonable court or attorney's costs involved in the collection of this account. More Info


*I have read and agree to the above terms:**	Yes No
*Company:**
*Contact:**
*Title:**
*Date:**

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