Credit Application

If you prefer you can download the Microsoft Word or PDF version for submission.
NET 30 TERMS - Your submittal of this application implies your acknowledgement and acceptance of the Net 30 invoice terms.
Business Trade Name*
Business Legal Name*
Business Phone*
Business Fax*
Billing Address*
Suite, Unit #
City*
State/Province/Region*
Zip/Postal Code*
Country*
Accounts Payable Information
(who to email invoices/question past due invoices)
Accounts Payable Contact*
Accounts Payable Email*

Please use your company email address. We may not accept requests that use Google, Yahoo, Hotmail, etc.
Accounts Payable Phone #*
Length of time operating the above named business:*
Length of time at the above address:*
Number of Employees*
Annual Sales Income (USD)*
Credit Line Desired (USD)*
For credit amounts requested below $50,0000, the customer must provide one (1) of the following. For credit amounts requested between $50,000 and $150,000, the customer must provide two (2) of the following. For credit amounts greater than $150,000, the customer must submit financials.

a) A credit report dated within a period of 12 months prior to Shipment, evidencing the creditworthiness for the credit being extended.

b) Reviewed or audited financial statements not older than 12 months from the financial year end, which indicate a shareholder’s equity of at least 3 times the credit limit set and show a retained profit before dividends.

c) Full management accounts including the Profit & Loss Account, Balance Sheet and Cash-Flow Statement, not older than 6 months prior to shipment, which indicate a shareholder’s equity of at least 3 times the Credit Limit set and show a retained profit before dividends.

d) Written trade references from two sources dated within the 12-month period prior to shipment, that evidence satisfactory payment experience on high credit amounts equal to at least 75% of the amount approved on similar payment terms.
Upload Financial Documents*
Drop files here or

Max. file size: 128 MB.
Sales Tax Information (U.S. Customers Only)
Only official state-issued tax certificates will be accepted.
Are you sales tax exempt?*
- Yes
- No
Please attach ALL tax exempt certificates [jpg, png, or pdf (version 7 or later)]*
Drop files here or

Max. file size: 128 MB.
D & B #
Federal Tax ID# (TIN)
Banking Information
Bank Name*
Bank Address*
Suite, Unit #
City*
State/Province/Region*
Zip/Postal Code*
Country*
Checking Account #*
Savings Account #*
Loan #*
Account Officer*
Account Officer Phone #
Account Officer Fax #
Account Officer Email

Please use your company email address. We may not accept requests that use Google, Yahoo, Hotmail, etc.
Credit References
Creditor 1*
Contact*
Phone*
Fax*
Email Address

Please use your company email address. We may not accept requests that use Google, Yahoo, Hotmail, etc.
Acct #*
Creditor 2*
Contact*
Phone*
Fax*
Email Address
Acct #*
Creditor 3*
Contact*
Phone*
Fax*
Email Address
Acct #*
Creditor 4*
Contact*
Phone*
Fax*
Email Address
Acct #*
Conditions
We authorize BCDVideo, Inc. to place orders only after receipt of our hard copy purchase orders and/or from signed quotes and we will pay for those orders as invoiced.
Your submittal of this application implies your acknowledgement and acceptance of the Net 30 invoice terms.
Authorization
We authorize BCDVideo, Inc. to place orders only after receipt of our hard copy purchase orders and/or from signed quotes and we will pay for those orders as invoiced. Your submittal of this application implies your acknowledgement and acceptance of the Net 30 invoice terms.
Signature*
Title*
Release of Credit Information
The customer for the purpose of obtaining credit submits this information sheet to BCDVideo, Inc. By signing this document the customer certifies that all information is correct to the best of the customer's knowledge. The customer hereby authorizes the release of credit and banking information to BCDVideo, Inc. by the references listed on these pages. Must be signed by authorized person on bank account.
Authorization
The customer for the purpose of obtaining credit submits this information sheet to BCDVideo, Inc. By signing this document the customer certifies that all information is correct to the best of the customer's knowledge. The customer hereby authorizes the release of credit and banking information to BCDVideo, Inc. by the references listed on these pages. Must be signed by authorized person on bank account. Your submittal of this application implies your acknowledgement and acceptance of the Net 30 invoice terms.
Signature*
Title*
Company represented*
Date*
MM slash DD slash YYYY
Captcha

Credit Application

Accounts Payable Information

Sales Tax Information (U.S. Customers Only)

Banking Information

Credit References

Conditions

Release of Credit Information