~ Discover the Processed at Sea Difference ~
PO Box 1230
Cordova, AK 99574 Email: sales@gulkanaseafoodsdirect.com
Phone: 907.424.5176 Toll Free: 877.253.5176 Fax: 907.424.3531 F/V Gulkana Onboard Satellite Phone: 254.460.6667
IMPORTANT: Incomplete applications will not be processed.
NEW
UPDATE Please print legibly
Circle one
Legal Name of Company:
DBA (if appropriate):
Billing Address:
Shipping Address:
City:
City:
State:
Zip:
State:
Zip:
Phone:
Fax:
Phone:
Fax:
Email Address:
Web Address:
Mobile Phone:
Accounts Payable Contact:
Phone:
Fax:
Email Address:
Does your organization require signatures on all outgoing purchase orders? Yes
No
Does any alternative billing address exist?
Yes
If yes, please attach a list of additional billing addresses.
No
If no, all invoices will be billed to the above address.
State of incorporation:
Registration No:.
Circle appropriate legal status:
Corporation
Partnership
Proprietorship
Federal Tax ID No.:
State Tax ID No.:
FedEx Account # or other applicable airline cargo account #:
Type of Business:
Date Business Established:
Banking Information
Bank Name:
Checking Account No.:
Address:
Savings Account No.:
City:
Contact:
State:
Zip:
Phone:
Fax:
CREDIT APPLICATION
Trade References
NOTE: In the event your establishment does not have trade references you may replace this with any references that your Establishment holds open