BobTest

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Owner/CEO Name:

Owner/CEO Phone:

Accounts Payable Contact Name (for payment inquiries):

Accounts Payable Contact Phone (for payment inquiries):

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Invoice Submission Instructions (Email Address, Portal Web Address, Etc.):

Finance Contact Name:

Finance Contact Phone:

Finance Contact Email:

Bank Name:

Bank Line of Credit:

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If Yes, Credit Amount Currently Available (USD):

If Yes, Line of Credit Account Number:

If Yes, Credit Limit:

Bank Contact Name:

Bank Contact Phone:

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Supporting Documentation

Attach any supporting documentation which should be referenced for credit consideration (credit references, company/organization credit overview forms, etc.

Order Information

Currency of First Order:

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Estimated Amount of First Order (in US Dollars):

Anticipated Annual Spectra Logic Purchases (in US Dollars):

Name of Person Completing Credit Application:

Title of Person Completing Credit Application:

Date:

Notes/Comments About Your Credit Application:

By submitting this application, you hereby certify that the information contained herein is complete and accurate. Additionally, by submitting this application, you acknowledge Spectra Logic is not obligated to extend credit. All purchases are subject to the terms of sale found HERE .

BobTest

Company Information

Company Information

Contact Information

Supporting Documentation

Order Information

Contact Us

Company Information

Company Information

Contact Information

Supporting Documentation

Order Information

Contact Us

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