MARYLAND METRICS - Credit Application by Fax or Mail
Please use this printable form if you would like to submit
a credit application via fax or mail.
This form is also available for downloading as a viewable/printable Acrobat PDF file.
[ View this form by clicking here ]
After the form has displayed, then print the form from your browser.
If your browser allows you to fill in forms, and want to send this credit application via e-mail then please click here to switch to our e-mail form.
Please complete the form below with enough information to assure accurate processing of the credit application. Our Fax numbers are: (800) USA-9-FAX [800-872-9329] or (410) 358-3142.   If you are submitting credit information on your own form, then just complete any items which are requested on our form, but are not included on your form.
Please check here _____ if you are also submitting credit information on your own form.


COMPANY NAME: ____________________________________________________
SHIPPING ADDRESS: __________________________________________________
2nd SHIP ADD. LINE: ___________________________________________________
CITY: ______________________________ STATE: ________ ZIP CODE:__________
PHONE NUMBER:_(____)___________ EXT.: _____
FAX NUMBER:_(____)_____________
E-MAIL ADDRESS: _____________________________
YEAR BUSINESS WAS ESTABLISHED: (must have)________________________


BILLING NAME and ADDRESS IF DIFFERENT THAN ABOVE: (You may omit any
information in the billing section below which is duplicated in the above
shipping section.)

COMPANY NAME: ____________________________________________________
BILLING ADDRESS: ___________________________________________________
2nd BILL ADD. LINE: __________________________________________________
CITY: ______________________________ STATE: ________ ZIP CODE:__________
PHONE NUMBER:_(____)___________ EXT.: _____
FAX NUMBER:_(____)_____________
E-MAIL ADDRESS: _____________________________
Into what business category would your organization fit?

OEM (Original Equipment Manufacturer)_____ DISTRIBUTOR **_____
MRO (Maintenance or Repair Operation) _____ END USER _____
GOVERNMENT AGENCY _____
**If you selected 'DISTRIBUTOR' above, then check the
appropriate product groups below.


FASTENERS:_____ HAND TOOLS:____ CUTTING TOOLS:____
MEASURING TOOLS:____ HYDRAULICS/PNEUMATICS:_____
METAL SHAPES:_____ OIL SEALS/O-RINGS:_____ GENERAL LINE:_____
MECHANICAL POWER TRANSMISSION EQUIPMENT:____ BEARINGS:_____
ELECTRICAL/ELECTRONIC:_____ PLUMBING SUPPLIES:_____
--------------------------------------------------------------------------
REFERENCES: (must have had activity within 1 year.)
BANK NAME:_______________________ ACCOUNT # (must have)________________
ADDRESS: ______________________________________________________________
CITY: ______________________________ STATE: ________ ZIP CODE:___________
PHONE NUMBER:_(____)__________ EXT.: _____
FAX NUMBER:_(____)____________
E-MAIL ADDRESS: _____________________________

REFERENCE No. 1 COMPANY NAME:______________________________________________
ADDRESS: ______________________________________________________________
CITY: ______________________________ STATE: ________ ZIP CODE:__________
PHONE NUMBER:_(____)___________ EXT.: _____
FAX NUMBER:_(____)_____________

REFERENCE No. 2 COMPANY NAME:______________________________________________
ADDRESS: _______________________________________________________________
CITY: ______________________________ STATE: ________ ZIP CODE:__________
PHONE NUMBER:_(____)___________ EXT.: _____
FAX NUMBER:_(____)____________

I hereby authorize Maryland Metrics to request credit information from the
above listed banks and trade credit references.

SIGNATURE:________________________ TITLE :________________ DATE:___________

You may fold this form so that the mailing address below fits a #10 window envelope.
Maryland Metrics (credit dept.)
P.O.Box 261
Owings Mills, MD 21117-0261 USA


*** Permission is hereby granted to print out and photocopy this particular page for the express purpose of submitting a credit application to Maryland Metrics.

Phones: (800) 638-1830 or (410) 358-3130 are available Monday-Friday 8:30 AM to 5:30 PM Eastern time.
Faxes: (800) 872-9329 or (410) 358-3142 & E-mail are available anytime.
Warehouse & showroom hours are Monday-Friday 10 AM to 5:30 PM.
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