Northcoast Label

North Coast Tape & Label, Inc.
24300 Solon Road
Bedford Hts., OH 44146
440-439-3200
Fax: 440-439-3201
800-969-4656

Company Information
Company Name		Phone
Contact Name		Fax
Address		Email
City State Zip
Accounts Payable Contact: Accounts Payable Phone:

Type of Business: Corp. Partnership Individual Owner

Bank Reference
Name		Account#
Address
City State Zip
Phone		Fax

Trade References (Name and address of firms with whom currently doing business)
1.	Company Name
	Address
	City State Zip
	Phone	Fax
	Highest Credit	When
2.	Company Name
	Address
	City State Zip
	Phone	Fax
	Highest Credit	When
3.	Company Name
	Address
	City State Zip
	Phone	Fax
	Highest Credit	When

Years in Business		Expected Annual Sales

Electronic Signature
By submitting this form I give approval for North Coast Tape & Label, Inc. to request information about our firm. If credit is not approved, I will be notified.
Your Name		Title