credit application 3

Credit Application

Please complete and submit the application for Quality Light Source Credit.

Business Contact Information


Duns D/B #
Companies requesting a credit line $10,000 or more must submit copies of their financial statements for the last two years.This information will be for the exclusive use of the credit department and will remain confidential.
Please attach financial statements or forms to define your financial backround. We can accept .doc, .docx, .txt, .pdf, .jpg, .jpeg, .png, and .gif files.

Business/Trade References


This application has been executed by an authorize agent of the customer and the information provided is for the purpose of obtaining credit and is warranted to be true. I/We hereby authorize Quality Light Source, LLC to investigate all references and custom credit information sources including consumer credit reporting regarding my/our credit and responsibility for the purpose of obtaining credit and for periodic review for the purpose of maintaining the credit application.
Please attach Sales and Use Tax Exemption Certificate and W-9 forms to your Sales Representative. Please see Quality Light Source Service Agreement for payment terms.