100 Hillside Drive, Drums, PA 18222, USA • Tel: 1-866-273-3243 • Email: jill.herring@jpcequestrian.com

INTERNATIONAL ACCOUNTS
Commercial Credit Application

Certain restrictions apply to internet only sellers. Please contact us for more information. 866-273-3243 or Sales@jpcequestrian.com.
* marked fields are compulsory.
Company Name*
Phone*
Fax
E-Mail*
Web Site
Billing Address*
City* State* Zip Country*
Shipping Address
Same as the Billing Address
Shipping Address*
(if different from above)
City* State* Zip Country*
Date Established*
Type of Entity*
Proprietorship Partnership Corporation Other
If Incorporated*
Yes No
If Incorporated
Date of Incorporation
Terms*:
Credit Card Wire Transfer
Principals/Owners - 1  
Full name*
Title*
Address*
Mobile*
Principals/Owners - 2  
Full name
Title
Address
Mobile
Principals/Owners - 3  
Full name
Title
Address
Mobile
Bank Reference  
Name*
Address*
Trade References - 1  
Name
Address
Phone
Fax
Trade References - 2  
Name
Address
Phone
Fax
Trade References - 3  
Name
Address
Phone
Fax
   
By*
Date*
 
Name of Authorized Agent
 
 
Title / Position*
 
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