Credit Application

Please complete and submit the form below to apply for credit with OEC. If you would instead like to fill out a PDF version to fax/email in, please click here.

= Required Field

Customer Information

Are PO's Needed? Yes No Tax Exempt? Yes No Delivery Preference: Packing Slip Invoice How many?

Name(s) of People with Authority to Place Orders

1. 2.
3. 4.

Company Information

Our legal entity is (check one) Corporation Co-Partnership Sole Partnership Government Agency
Number of years in business: Type of business:

If a corporation, list the names of Officers and Titles. If other entity, list the names of partners or owners.

Principal Name Address City/State/Zip Phone

If the business is a division or a subsidiary, list the complete name and address of the parent company.

Name: Invoices paid by: Division/Subsidiary Parent Company
Address: City: State: Zip: Dun and Bradstreet No:

Bank Affiliation

Bank Name: Account No: Bank Officer: Dept:
Address: City: State: Zip: Phone:


Company Name Address City/State/Zip Phone

We certify that the information provided above is correct and that we fully understand your credit terms are net 15 days. We agree to the Standard Terms and Conditions of Sale and agree to proper payment in consideration of extended credit.

Agree to terms above.

Your Name: Title:

*Please only click submit once. May take a moment.