Credit Application for Lamers Enterprise

Credit Application for Lamers Enterprise

Go here to download Credit Application.
When you are done, please either email to us or fax to our office at: 808-845-5592.

		BUSINESS CREDIT APPLICATIONS
Lamers Enterpris, Inc
251 Puuhale, Road,						For fast credit Approval
Honolulu, Hi 96819						Please fax to:
PH: 808-845-9365						808-845-5592
Attn: Credit Division				Sale Rep	Ernie Kim
Type of Business		_____________________________________________
Phone number		_____________________________________________
Fax number		_____________________________________________
					City	State	Zip
Billing address		_________________________________________					__________________
Shipping address		_________________________________________					__________________
Type of ownership		__ Corporation		__ Partnership		__ Sole Proprietor
		__ Government		__ Non- Profit		__ Others_________________
Years in business		________	Years	Tax Exemption?  ____ yes,  ____ No,
Parent company's name (If  different than above):
Address		________________________________________________________________
					City		State	Zip
				BANK REFERENCE
Bank name		_________________________	________________		________________		__________________
Account #		_________________________			Phone number		Fax number
Contact at bank		_________________________
Bank name		_________________________			________________		__________________
Account #		_________________________			Phone number		Fax number
Contact at bank		_________________________
			OPEN ACCOUNT REFERENCE- Locals only
Name of business					________________		__________________
					Phone number		Fax number
Address		________________________________________________________________
					City		State	Zip
Name of business					________________		__________________
					Phone number		Fax number
Address		________________________________________________________________
					City		State	Zip
Name of business					________________		__________________
					Phone number		Fax number
Address		________________________________________________________________
					City		State	Zip
Authorized Signature		_________________________			Date	_________________________
Print name		_________________________			Title	_________________________
Inter Office use only			Date approved		Date	_________________________
Credit limit             $		_________________________			Note	_________________________