Application For Commercial Credit

Birmingham Fastener


Please complete the following information. This will avoid processing delays on your application.

Sales Rep #:
Legal Company Name:
* Billing Address:
* Billing City:
* Billing State:
* Bill Zip:
Shipping Address(if different from billing):
Shipping City:
Shipping State:
Shipping Zip:
* Main Business Phone #:
Main Business Fax #:
In Business Since:
# of Employees:
Applicant is Proprietorship:
Partnership: Gen.:
List: Federal ID # or SS#:
Tax Exempt #:
Describe your primary business:
Es. Annual Purchases from BFI:
President's Name:
Do you require a Purchase Order number on all invoice?
Purchasing contact:
Purchasing Contact Phone #:
Purchasing Contact Fax #:
Accts. Payable Contact:
Accts. Payable Contact Phone #:
Accts. Payable Contact Fax #:
Bank Name:
Acct. #:
Bank Phone #:
Bank Address:
Bank City:
Bank State:
Bank Zip:
Trade Name:
Trade Phone #:
* Trade Fax #:
Trade Address:
Trade City:
Trade State:
Trade Zip:
Trade Name:
Trade Phone #:
* Trade Fax #:
Trade Address:
Trade City:
Trade State:
Trade Zip:
Spam Prevention Code:   
Enter Spam Prevention Code:

* Required Field


Customer Acknowledgment of Selling Terms and Conditions

If this application is accepted by Birmingham Fastener & Supply, Incorporated, Huntsville Fastener and Supply, Incorporated, or Dallas Fastener, Inc. (its affiliates and/or subsidiaries) (BFI), then Applicant agrees to the BFI Terms & Conditions of Sale, found at Without limiting the forgoing, Applicant agrees that payment is due N-30 days from invoice date. A late charge of 1 1/2% per month is assessed to an account past due; and, Applicant in the event of default and that legal action or an outside service shall become necessary to effect collection for the merchandise, product or service purchased from BFI, Applicant agrees to pay all cost of collection, including reasonable attorney fees, interest and all court cost incurred. Applicant authorizes BFI to obtain a written or oral credit report from any credit reporting agency, bank or commercial business with whom the applicant is or has done business, and, agrees to assist BFI in the credit investigation and any re- investigation.


Please attach a copy of your tax exempt certificate or taxes could be charged to your purchases.

Business References -  Please include fax numbers to speed our Credit investigations.