STEEL WORKS STAINLESS

Dealer Inquiries Forms

CUSTOMER APPLICATION

5805 Peachtree Corners East Suite A Peachtree Corners, GA 30092
(770) 864-1780)

Return this application to ap@steelworks-stainless.com(770) 864-1780)

In order to process your application, this form must be filled out in total, and must be signed by an officer or principal of the firm

Firm Name:

Billing Address:

City:

State:

Zip Code:

Street Address:

Corporate. Phone:

Corporate Fax:

Accounts Payable Phone:

Accounts Payable Fax:

Tax Resale #
(Please submit form) :

Federal ID:

Corporation: Principals &
Titles

Partnership or Proprietorship
Name:

S/S #:

Name:

S/S #:

Date Business Established :

Years at Present Location:

How did you learn about our company? :

Bank Reference:

Account # :

Bank Address:

Phone #:

City, State and Zip:

Fax #:

Bank Contact:

Email:

Trade References (major supplier names)

1. Name:

City, State, Zip:

Telephone/Fax #:

Contact:

Email:

2. Name:

City, State, Zip:

Telephone/Fax #:

Contact:

Email:

3. Name:

City, State, Zip:

Telephone/Fax #:

Contact:

Email:

The undersigned certifies that the information provided above and on the attached financial statement, if any, is complete and accurate. The
undersigned further grants the bank and trade references permission to release pertinent information to BHG Partners LLC DBA SteelWorks regarding
their credit status. The undersigned further agrees that all quotations and sales by BHG Partners LLC DBA SteelWorks, its subsidiaries or affiliates, are
subject to BHG Partners LLC DBA SteelWorks’ standard terms and conditions and in the event of litigation relating in whole or in part to any credit
offered as a result of this application, BHG Partners LLC DBA SteelWorks shall be entitled to its reasonable costs and expenses incurred, including
attorney’s fees and the costs and expenses of enforcing or collecting upon any resulting order or judgment

TEL: 770-864-1780

FAX: 770-680-5953

Mon-Friday 9am to 5pm EST

CUSTOMER APPLICATION

TEL: 770-864-1780

FAX: 770-680-5953

Mon-Friday 9am to 5pm EST

TEL: 770-864-1780

FAX: 770-680-5953

Mon-Friday 9am to 5pm EST

CUSTOMER APPLICATION

TEL: 770-864-1780

FAX: 770-680-5953

Mon-Friday 9am to 5pm EST

TEL: 770-864-1780

FAX: 770-680-5953

Mon-Friday 9am to 5pm EST

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