Credit Application

All statements made herein shall be true and accurate to the best of your knowledge. Upon approval of this application, the applicant hereby agrees to pay the account in full within 30 days from the date of invoice. In the event it becomes necessary for Build Source, Inc. to refer outstanding balance(s) to a collection agency /attorney, all reasonable collection/legal fees will be paid in full by the debtor. The applicant further agrees to the above credit terms and such other terms and conditions that are set forth in Build Source, Inc. invoices. In addition, the applicant authorizes the release and exchange of credit information relating to this application.

Step 1 of 3

33%

Company Name*
Type of Entity*
DUNS Number
Website
Company Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Company's Responsible Person (Name)*
First Last
Title*
Email*
Phone*
Accounts Payable Person's Name (if different)
First Last
Email
Phone
Maryland State Sales Tax Status*
- Tax Exempt in Maryland
- Not Tax Exempt in Maryland

Business Reference #1 (Name)*
First Last
Title*
Company Name*
Phone*
Email*
Business Reference #2 (Name)*
First Last
Title*
Company Name*
Phone*
Email*
Business Reference #3 (Name)*
First Last
Title*
Company*
Phone*
Email*
Email
This field is for validation purposes and should be left unchanged.