Business Credit Application

Business Credit Application

Please complete this form with all the relevant information in order to process your application.

Company Information
Doing Business as a*
Bank References
Trade Reference 1
Trade Reference 2
Authorization for Direct Payment via ACH (ACH Debits)

Direct Payment via ACH is the transfer of funds from a bank account for the purpose of making a payment. I (we) authorize APS Marketing Group to electronically debit my (our) account on a monthly basis (and, if necessary, electronically credit my (our) account to correct erroneous debits'). Please complete the following form below to get started!

Bank Account Type*

I (we) understand that this authorization will remain in full force and effect until I (we) notify APS Marketing Group [insert manner of revocation, i.e., in writing, by phone, location, address, etc.] that I (we) wish to revoke this authorization. I (we) understand that APS Marketing Group requires at least (30 days] prior notice in order to cancel this authorization. I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein.