toll-free: 1-866-650-1937 ph: 704-846-2004 fax: 704-847-0522 email: sales@ecompressedair.com
Corporate HQ: 7255 East 46th Street, Tulsa, OK 74145
Sales office: 2201 Crown Point Executive Dr., Suite A, Charlotte, NC 28227

Credit Application

To request net 30 terms with eCompressedair, please complete the below form. Or click here for a pdf version of our credit application. Please fill out the application and fax it to 704-847-0522.

*Company Name
Billing Address
City
State
Zip
Country
*Phone
Fax
*Email
Shipping Address
City
State
Zip
Country
Credit Information:
Estimate of credit requested:
Type of business:
D & B #
Tax ID or SS#:
Years in Business:
Credit References:
Bank Reference Name:
Account #:
Phone:
Fax #:
Trade Reference Name:
Account #:
Phone:
Fax #:
Trade Reference 2 Name:
Account #:
Phone:
Fax #:
Trade Reference 3 Name:
Account #:
Phone:
Fax #:
Is applicant subject to sales tax?
Tax Exemption Number:
Please advise if Parent, Division, Branch or Subsidiary:
This section to be completed by Proprietorship or Partnerships. Name of owner or authorized persons who will be responsible for payment of account. (Minimum of two references.)
Name:
Address:
Phone:
SS#:
Bank (Personal):
Position or Title:
Name:
Address:
Phone:
SS#:
Bank (Personal):
Position or Title:
By submitting this form the applicant acknowledges that should credit be approved, the terms are net 30, from the date of invoice. Invoices not paid within these terms may be subject to a service charge.

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