Brands

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Credit Account Application

Please fill out the online credit application and submit to Emergency Medical Products.
Business Type


Address
Contact Information

Name and address of individuals or partners - Name / Title / Phone number of corporate officers

Name of persons to contact regarding purchase orders and invoice payment, title and phone number

Account Number, Contact, Title and Phone Number

Company Name, Complete Address, Phone/Fax Number(s) and Account Number

I (We) agree to pay all bills for purchases net 30 days from the date of invoice and thereafter any invoice over 30 days a 1 1/2% per month will be added to unpaid balance after invoice. The above information is herewith submitted for the purpose of opening an account and I do hereby certify this information to be true.

Please type the above security code in the box.