APPLICANT BUSINESS INFORMATION
Applicant Name: 
Business Telephone: (  )  - 
Applicant Legal Name: 
Street Address: 
City:  Prov:  P.C.: 
Billing Address: 
City:  Prov:  P.C.: 
Accounts Payable Contact: 
Nature of Your Business: 
Have you had an account with OH Armstrong Ltd.previously? Yes No
Name, address, and telephone number of account, if yes

APPLICANT REFERENCES
Trade reference name: 
Phone: (  )  -  Fax # : (  )  - 
City:  Prov:  P.C.: 
Trade reference name: 
Phone: (  )  -  Fax # : (  )  - 
City:  Prov:  P.C.: 
Bank reference name: 
Phone: (  )  -     Chequing Account # :

Signature of Applicant


Title: 

Date: 

OFFICE USE ONLY
OHA # :  Estimated charge each billing period: 
Received by Credit Department:  Date processed: 

After you have completed the application, print it out, and sign where applicable.   then fax the completed application to 902-765-3856 or mail it to OH Armstrong Ltd. Credit Department,

 P.O. Box 220, Kingston, Nova Scotia, B0P 1R0.