Online Line of Credit Application Please complete all fields before submitting this application. You will need to provide three (3) credit references and a bank reference. We will review your application as expediently as possible. In the interim, you will receive an account number via email within the next business day, Monday through Friday 7:30am - 5:00pm EST so that you may place orders with Briggs using a major credit card. You will also receive a username and password for access to online ordering, pricing and product availability via our web site. Thank you. How did you hear about C.H. Briggs? ---Select One--- BKBG C.H. Briggs Sales Rep CWB Magazine (Custom Wood Business) Cabinet Maker Magazine Friend/Associate Referral K&BB (Kitchen & Bath Business) K&BDN (Kitchen & Bath Design News) Literature, Sales Flyer or Truck Manufacturer Sales Rep Manufacturer Web Site Other Search Engine Trade Association Trade Show Wood Digest Woodweb Web Site Wood & Wood Products Magazine If other, specify: First Name: Last Name: Company: How will your www.chbriggs.com registration assist you as it relates to your position in your organization? Look up products, check pricing & product availability Purchase products Both Phone: Fax: Email: *required Yes  No   Would you like to receive via email shipping notifications? (Currently for UPS Only) Accounts Payable Contact: Email: Fax: Email   Fax  US Mail     How would you prefer to receive your invoices? Tax ID#: (EIN#)   None (If no Tax ID# is entered you will be contacted to provide a voided business check) SIC Code#:   Not Known Billing Address Address 1: Address 2: Address 3: City: State:                                                      County: ---Select One--- ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WASHINGTON, D.C. WEST VIRGINIA WISCONSIN WYOMING         Zip: Ship to the same address? Note: State sales tax will be charged unless a signed resale exemption form is returned. Applicable states: AL, FL, DC, GA, MD, MI, NC, NJ, NY, OH, PA, SC, TN, VA. A physical copy of your tax exemption certificate must be provided. This can be faxed to our credit department at 610-921-4834 or mailed to our credit department at C.H. Briggs Company., P.O. Box 15188, Reading, PA 19612-5188. * No P.O. Box Allowed in Shipping Address Shipping Address 1: Shipping Address 2: Shipping Address 3: City: State:                                                      County: ---Select One--- ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WASHINGTON, D.C. WEST VIRGINIA WISCONSIN WYOMING         Zip:   You must complete all fields before going to step 2. Thank you.