Unitek Information Technologies

Credit

To establish your account with Unitek Information Technologies, please be sure to fill out the application accurately and completely. Fields marked with * are required. Click on the SUBMIT button.

When your credit application is approved, you will be contacted by the account executive assigned to your account. If you have any questions regarding filling out the credit application, call 877.686.4835, Monday through Friday, 9:00 a.m. to 6:00 p.m., for assistance.

Company Information
*Full Legal Name of Company		*Telephone No.
DBA		Fax No.
*Address(Street)	*City	*State	*Zip
*Contact Person		*E-mail address
*Industry of business	DUNS #(if applicable)	*Nature of Business	*Date Started
Personal Information on Officers, Partners or Guarantors
OWNER 1		OWNER 2
*Owner/officer(s)		Owner/officer(s)
*Social Security No.	*Title	Social Security No.	Title
*Home Address	*City	Home Address	City
*State	*Zip Code	State	Zip Code
Bank Credit References
Please provied two years of bank references.
BANK 1		BANK 2
*Name of Bank / Branch		Name of Bank / Branch
*Bank Address		Bank Address
*Contact Officer	*Telephone No.	Contact Officer	Telephone No.
*Checking Account #	*Date Account Opened	Checking Account #	Date Account Opened
Enter Text Below:

The applicant has a right to a statement of the specific reasons if any adverse action has been taken. To request this information, contact our ECOA compliance Dept within 60 days of receipt of this adverse action notification. The department can be reach by writing to: 1005 Westlakes Drive, Berwyn, PA 19312 or calling (610) 651-5141. Please reference the application number on the notice. We will provide you with a statement of the specific reasons for the adverse action within thirty (30) days after we have received your request. NOTICE: The federal equal credit opportunity act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract) because all or part of the applicant’s income derives from any public assistance program or because the applicant has in good faith exercised any right under the consumer credit protection act. The federal agency that administers compliance with this law is the Federal Trade Commission Equal Credit Opportunity, Washington, D.C. 20580 I HEREBY AUTHORIZE LESSOR OR ANY CREDIT BUREAU OR OTHER INVESTIGATIVE AGENCY EMPLOYED BY LESSOR TO INVESTIGATE THE REFERENCES HEREIN LISTED OR STATEMENTS OR OTHER DATA OBTAINED FROM ME OR FROM ANY OTHER PERSON PERTAINING TO MY CREDIT AND FINANCIAL RESPONSIBILITY. I have read this application, and everything I have stated in it is true. Submit my application. By electronically transmitting this application, I indicate my agreement with each of the conditions described above.