Omni Cable Credit Application


Credit Application must be submitted online
(No Handwritten/Fax/Email applications will be accepted)

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BILLING ADDRESS

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SHIPPING ADDRESS

Check if shipping address is same as billing address
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AP CONTACT INFO

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Method for Receiving Invoices

TYPE OF ENTITY

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If Partnership or Sole Proprietor Please Complete This Section:

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COMPANY INFO

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Please upload a copy of your tax exempt certificate below or fax it to: 610-701-0199


FINANCIAL INFO

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Credit Lines over $100K require financial statements (last 2 fiscal years: balance sheet & income statement)


In lieu of attaching financials, please complete the attached summary information to help us better assign the credit line you need.
Please use most recent financial information

BANK & TRADE REFERENCE

Please select to either upload a copy of your bank and trade references or fill out the form below

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TYPE OF ACCOUNT(S):

      

Trade Reference 1

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Trade Reference 2

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Trade Reference 3

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AUTHORIZATION


You authorize Omni Cable Corporation to obtain a credit report for the purpose of establishing, maintaining or enforcing a credit line.

You authorize the above listed bank and trade references to release any credit or financial information that maybe requested.

You fully disclose that all financial information provided are accurate and taken from audited or internally prepared financial statements.

Upon approval of credit, you agree to pay your account according to the terms granted.

Omni reserves the right to assess late fees should your account fall past due.

Check box to confirm you are an authorized representative of the company and agree to all above Terms and Conditions of Sale.

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Please click Submit below.
Any questions, please email AR@omnicable.com

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