Credit Application

 

Please provide us with the following information so that we may open an

account for you.

Store Name:____________________________________________________________

Trade Name (If different):__________________________________________________

Store Address:___________________________________ Tel:___________________

City:_____________________________  State:________  Zip:___________________

Person to contact in financial matters:_______________________________________

Name of Principle(s):_____________________________________________________

Bank Reference	Trade Reference
Name______________________________	Name________________________________
Address____________________________	Address______________________________
City_____________  State___  Zip______	City______________  State___  Zip_______
Phone_____________________________	Phone_______________________________
Contact Person______________________	Contact Person________________________
Trade Reference	Trade Reference
Name______________________________	Name________________________________
Address____________________________	Address______________________________
City_____________  State___  Zip______	City______________  State___  Zip_______
Phone_____________________________	Phone_______________________________
Contact Person______________________	Contact Person________________________

 

 

 

Charles Stern, Inc., 30 West 47th Street, NY 10036, (800) 552-0234,  (212) 869-8948. 

                          

 

                                                Order Form

 

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                                      Orders may be faxed to (212) 719-0763

 

                                     or sent to: Charles Stern, Inc., 30 West 47th Street, NY 10036.

                                     or by calling toll free: 800-552-0234.  In NY (212) 869-8948.

 

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