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Date:
Company's legal business name:
Number of years in business:
Sales Contact's name:
Sales address:
Sales telephone (Extension ):
Sales Fax Number:
Sales e-mail address:
Accounting contact's name:
Accounting remit to address:
Accounting telephone (Extension ):
Accounting Fax Number:
Accounting e-mail address:
Country:
Federal Tax ID number (for U. S. Vendors only ):
Account number assigned to velocity Electronics:
Banking information (if terms are TTA): Bank Name and branch:
Bank address:
Beneficiary Name:
Swift code *:
Bank Key *:
Your account number:
Did you receive our bank & Trade, insurance binder, and resale certificate: Yes/No
Payment terms extended to velocity Electronics
[Net 30, TTA, cod, escrow, CCA (American Express), CCV (Visa)]:
Signature authorizing the above payment terms
(Does not have to be signed if terms are cod or escrow ):
* Swift-Society for Worldwide Interbank Financial Telecommunication
* Bank Key-specify the bank key under which your bank data from the respective country is stored.
Below is for velocity electronics use only
Velocity electronics Acct Mgr's name: Matthew Rubino
Acct Mgr-is this a franchise distributor? Yes/No
Accounting depart approval demo-: yes/no
Approved by (name, signature, and date ):
Date:
Company's legal company name: number of years in the transaction:
Sales Contact's name:
Sales address:
Sales phone (Extension ):
Sales region No:
Sales Email:
Accounting contact's name: the account sending Address of the speech:
Accounting telephone (Extension ):
Accounting region No:
Accounting Email:
Country:
Federal Tax ID number (only for us vendors ):
The account number is allocated to the speed electronic:
Banking information (if the term is TTA): Bank Name and branch:
Bank address:
Beneficiary Name:
Swift code *:
Bank Key *:
Your account:
Did you accept our bank & Trade, insurance adhesive and reseller certificates: yes or no
Payment period extended to speed electronic
[Network 30, TTA, cod, trust property, CCA (US Express), CCV (Visa)]: Approve the signature of the above payment term
(Signatures are not required, if the term is COD or trust property): * swift-Society of Financial Telecommunications across banks worldwide
* Bank Key-specify the key of your bank data stored in your country.
Below is used for speed electronic only
Velocity electronic Acct Mgr's name: Matthew Rubino
Acct Mgr-is this a privileged dealer? Yes or no
The decision of accounting's departure identity: yes or no
Approved (name, signature, and date ):