Brydens Xpress Credit Application / Website Registration Form

Brydens Xpress (Office Supplies) Inc.
Lower Estate Factory Complex, St. Michael, Barbados
Tel:(246)431-2646 Fax:(246)426-3556 Email:sales@brydensexpress.com

CREDIT APPLICATION / WEBSITE REGISTRATION FORM

Please fill out the form below and click the Submit Form button at the bottom ONCE when completed. The completed form will be displayed. Please use your browser to print this form (File > Print). Sign the form and either fax or mail it to us. Existing Brydens Xpress customers please note that this form must be filled out in order to use the website.

Company's Name (or "Trading as"):
Address:
Applicant's Full Name:		Position Held:
Commence Date of Business:		Fax Number:
Telephone Number:		E-Mail:

Please list three unrelated (to your company) businesses in Barbados as references for your company.

Business #1:

Tel:

Address:

Business #2:

Tel:

Address:

Business #3:

Tel:

Address:

Name of Bank:

Tel:

Address:

Please indicate if you have a current credit account with any other ANSA McCAL Group Company:

	Stokes and Bynoe		Brydens Business Solutions		A & R Tempro
	Brydens Distribution		McEnearney Quality		Consolidated Finance

PLEASE PROVIDE COPY OF LETTER OF INCORPORTION
Terms and Conditions under which Credit Facilities are granted.

All invoices are payable in full by the end of the month following the invoice date.

Late payments are subject to a Service Charge of 1.5% per month.

A $50.00 charge is payable on any debtor's cheques that are returned by the debtor's bank due to insufficient funds available in the debtor's account to process the cheque.

In the event that non-payment causes an account to be turned over to an attorney or other agency for collection, the debtor will pay all legal fees and expenses including debt collection fees.

We the undersigned, agree to the above terms and conditions and warrant that the above information is true and correct.

Date: ___________________________________

________________________________________
Signature of Director/Secretary of Applicant

________________________________________
Please Print Name