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- Closeout Items -
Abrasives
Cutting Tools
Fluids / Chemicals
Hand Tools
Indexable Tooling / Inserts
Machinery
Material Handling
Measuring Tools / Gages
Plant & Safety
Pneumatic Tools
Workholding / Fasteners
ITEM # QTY.
   

 

Opening your account with RMP Industrial Supply has never been easier. Either fill out the online credit application below, or call and let us know you would like to open an account and we will fax or mail you the application.

Fields with an ' * ' must be completed

Company Name or Individual*

Mailing Address*

City* State* Zip*

Shipping Address

City State Zip

Phone* Fax* E-Mail

Names & Titles of Officers, Owners and/or Partners*

Amount of Credit Requested (US Dollars)*

Are Purchase Orders Required?* yes no

Are any of your Purchases Exempt from Sales Tax?* yes no

- BANK REFERENCE -

Name*

Mailing Address*

Street Address

City* State* Zip*

Contact Officer* Phone*

CREDIT REFERENCES (3 REQUIRED)
Note: Local References will speed the application process.

Company 1*

Mailing Address*

City* State* Zip*

Phone* Fax*

Company 2*

Mailing Address*

City* State* Zip*

Phone* Fax*

Company 3*

Mailing Address*

City* State* Zip*

Phone* Fax*

Terms of an open account:
- 30 days from date of invoice
- late payments may result in your account being placed on HOLD

Name and Title of Authorized Person Making This Application*

I, (person named above), certify that the above information is true and correct to the best of my knowledge.*

yes no        Date*

<Please review all your information before submitting>


  Due to the size of this form it may take a few minutes to submit, to avoid duplications of your request please only hit button once, Thank You.