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Customer Information
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Postal Code:
Telephone No.:
Fax No.:
Email Address:
Date Established or Incorporated:
Accounts Payable Contact:
GST No.:
Owner(s) Name(s):
Bank Information
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Postal Code:
Account Number:
Contact:
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Extension:
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Credit References
Company Name:
Address:
City:
Province/State:
Postal Code:
Contact:
Telephone No.:
Extension:
Fax No.:
Company Name:
Address:
City:
Province/State:
Postal Code:
Contact:
Telephone No.:
Extension:
Fax No.:
Other Information
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Credit Days Requested:
Credit $US Requested:
Note:
Subject to the Standard Trading Conditions of CIFFA available at http://www.ciffa.com.