Confidential Credit Experience Request
CONFIDENTIAL CREDIT EXPERIENCE REQUEST
To:
Fax:
Date: 09/29/2023
One of your customers:
has listed your company as a credit reference.
Can you please fill up and submit this form online
(recommended)
or by
Fax: 514-354-5211
or
Email:
[email protected]
at your earliest convenience. Thank you very much.
REFERENCE
, - Phone:
How long has his account been open?
Terms of sale?
What is the highest shipment amount sent to the customer in the last 12 months?
In the past 12 months, has the customer been overdue for more than 25% of the amounts due?
Yes
No
What is the highest receivable balance reached with this customer?
How long does it take to pay you? (days)
Between (minimum)
and (maximum)
Current Balance
31-60 days
61-90 days
More than 90 days
Bounced checks?
Yes
No
Overall, how would you rate this customer?
Safe
Stable
To monitor
-Lately, have there been any changes in payments or purchases?
Yes
No
Any Comment?
Submit Form
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