Heritage Application for Open Account Status


Dealers: Please use our Dealer Credit Application.
Heritage Personal Credit Application

Application Details
Date   04/19/2014
Maximum Requested   $
Salesperson  
Auction  
What prompted you  
to contact Heritage?  


Personal Information
* indicates a required field
Name*  
Heritage Client #  
(if known)  
Home Address*  
(No PO Boxes)  
City*  
State*  
Zip*  
Home Phone*  
Social Security Number  
Optional: Your SS# is not required, but providing it typically allows us to grant larger open account lines than we would normally be able to provide. If you would like to provide it, but would rather do so offline, please check the box and a Heritage representative will contact you via phone to complete the process.
Fax  
Email  
Website  
eBay User Name  


Employment Information
Company Name  
Position  
Address  
(No PO Boxes)  
City  
State  
Zip  
Telephone  
   ext  
Fax  
Email  
Website  
Type of Business  
Self-employed  
Tax Resale Number  
Annual Income  
Years Employed/Owned  


Bank Reference
Bank  
Account Number   Business    Personal
Address  
(No PO Boxes)  
City  
State  
Zip  
Telephone  
Fax  
Contact Person  


Collectible Dealer Credit References
Please list three dealers or auction companies with which you have credit.
Company  
Telephone  
Address  
City  
State  
Zip  
Contact Person  
Recent High Credit  

Company  
Telephone  
Address  
City  
State  
Zip  
Contact Person  
Recent High Credit  

Company  
Telephone  
Address  
City  
State  
Zip  
Contact Person  
Recent High Credit  
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