Confidential Credit Application
*Company name:
*Billing Address: (Location Invoices are sent to or location where billing clerk resides)
*City:				*State:			*ZIP Code:
County:				Billing Currency:
Phone:				Fax:
E-Mail:				*Years in Business:
* Sole proprietorship Partnership Corporation LLC Other
LEGAL COMPANY INFORMATION / LEGAL ENTITY AND RESPONSIBLE PAYER
Company name: (Legal Payer NAME only if different than the Bill To Name)
Legal Paying Address: (Location that remits payment)								Same as Bill to Address?
City:				State:			ZIP Code:
Phone:			Fax:
E-Mail:
SOLD TO INFORMATION / PURCHASING LOCATION
Sold To Address: (Address on Purchase Order)								Same as Bill to Address?
City:				State:			Zip Code:
Phone:			Fax:
E-Mail:
COMPANY BANK INFORMATION
*Bank name:
*Bank address:					*Phone:
*City:				*State:			*ZIP Code:
*Type of account:			Account number:				Bank routing number:
Savings:
Checking:
Other:
SUPPLIER / CREDITOR REFERENCES REFERENCES FROM YOUR OTHER SUPPLIERS
Company name:
Address:
City:				State:			ZIP Code:
Phone:			Fax:				E-mail:
Company name:
Address:
City:				State:			ZIP Code:
Phone:			Fax:				E-mail:
JOHNS MANVILLE CONFIDENTIAL CREDIT APPLICATION FOR A BUSINESS ACCOUNT
Check implies agreement to all Johns Manville Terms and Conditions.
* Applicant accepts Johns Manville Terms & Conditions
*Name of Firm:
*Signed By:
*Print Name:
*Title:
*Date:
CREDIT APPLICATION NOT ACCEPTED WITHOUT APPROVAL OF JOHNS MANVILLE CREDIT DEPARTMENT. THIS MUST BE SIGNED, SCANNED AND UPLOADED.
TAX INFORMATION - Please submit your HARD COPY Tax Resale certificates with this application
Tax is accessed based on the state in which material is received. Please provide a copy of the signed /dated resale certification for each state in which material will be received, or a multi-jurisdiction form for multiple states. (JM’s business policy is that tax certificates are renewed every 3 years)
*Resale Certificate Scans: You may also mail physical copies.
*Federal Tax ID:					Please provide your Federal Tax ID for JM reporting purposes only
Please Note, if required for your systems, the Johns Manville Federal Tax ID #: 13-0889690
SHIPPING LOCATION INFORMATION – Physical location of deliveries if different than Sold To on page one
Multiple Ship To's				Please provide listing to your Johns Manville Account Manager
Address:
City:				State:			ZIP Code:
County:				Special Taxing Jurisdiction:
Delivery Phone:				Fax:			Delivery Hours: