11 Industrial Drive
Monett, MO 65708
1-800-950-8473

Friend Tire Company

NEW CUSTOMER SET UP SHEET AND APPLICATION FOR CREDIT
Fill out the following page and we will process your application.
*First Name:
*Last Name:
*Dealership Name:
*Email Address:

Date:		*FED ID#:
Acct#:		*Phone:
Firm's Name

Shipping Address:
City:		County:
State:		Zip:

Billing Address:
Phone:		Fax:
City:		County:
State:		Zip:

# of Years in Business		Purchasing Agent
Type of Business		State of Incorporation
Branch/Subsidiary of		Nature of Business
Years at Present Location		Location
Credit Limit Requested $		Annual Sales $

Accounts Payable Manager
Phone		Fax

Bank Name
Phone		Account #
Bank Address		City
State		Zip
Bank contact Person
Phone		Fax
Type of Account		Loan $
Secured by Inventory		Accts Receivable?

Owners and Officers Are:
*Name		*Title
SSN		Phone
Home Address
Name		Title
SSN		Phone
Home Address

Accountant's Name
Address
Phone		Fax

Suppliers Which Ship On Open Accounts: (information required to establish charge account)
Name		Acct#
Phone		Fax
Address		City
State		Zip
Name		Acct#
Phone		Fax
Address		City
State		Zip
Name		Acct #
Phone		Fax
Address		City
State		Zip
Name		Acct #
Phone		Fax
Address		City
State		Zip

Friend Tire Company has six distribution centers located nationwide. Below, please select the distribution center in which you will directly be doing business and receiving inventory. A copy of the above application will be sent to the corresponding branch manager and Friend Tire corporate. You will be contacted once your new account has been approved. If you have additional questions, please call us at 1-800-950-8473. And thank you for your interest in Friend Tire Company.
*Distribution Location: