Credit & Account Request

Amano McGann - Credit & Account Request

Submitter Information

Please complete all required fields. Additional fields will appear based on your selections.

First Name

Last Name

Submitter Phone

Submitter Email

Sales Rep / Amano McGann Contact

Who is filling out this form?

External Customer

Amano McGann Employee

Internal Access Code

External customers: select External Customer above to submit a New Customer request. Amano McGann employees: choose Amano McGann Employee and enter the internal access code to unlock the internal request menu.

Request Type (External)

Request Type (Employee)

New Customer

Business Name (Bill To)

Bill To Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Ship To Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Customer Website

First Name

Last Name

AP Contact Email

AP Contact Phone

Tax ID Number

Are you tax exempt?

Yes

Attach exemption or resale certificate

Choose File

Account Type

Requested Credit Amount

Attach proposal or quote

Choose File

Change Existing Account

Customer Number

Branch Number

Bill To Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Ship To Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Please describe what needs to be changed

Add New Location

Customer Number

Branch Number

Ship To Address (New Location)

Address Line 1

Address Line 2

City

State

Zip Code

Country

Is additional credit needed for this location?

Yes

Requested Credit Amount (New Location)

Attach proposal or quote (New Location)

Choose File

Existing Customer Credit Check Only

Customer Number (Existing)

Credit Amount Needed

Attach proposal or quote (Existing)

Choose File

Additional comments or notes