Credit Application

Fill out form below or download form here and fax back to (757) 460-5555

Credit Application
Is Applicant *
Tax Exempt *
PO Number Required? *

Credit References:

Please fill this section out in full

Bank Information

Trade References

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Credit Amount applied for:PER MONTH

Person(s) Authorized to Request Service for this Customer

I / We hereby authorize Atlantic Heating & Cooling Service, Inc. to obtain any credit or other information from whatever sources they may consider appropriate in order to establish and maintain a credit account in my/our name. I / We understand that all invoices are due and payable fifteen (15) days from date of invoice and personally agree to pay 1.5 % interest per month (18% per annum) or as otherwise specified from time to time on the invoices rendered, on amounts overdue, in addition to any collection, court and legal costs that may be incurred in order to collect amounts that may become delinquent hereunder in the amount of 33%. All returned checks are subject to $50 return fee.

Please Check Box *