How to Place an Order with National Azon Equipment for Canon Equipment, Accessories or Inks Ordering from National Azon Equipment is easy… First time customers, please fill out the credit application on the second page of this document. You may email or fax your orders to the locations listed below. If you have pricing, delivery or confirmation questions please contact our customer service department. Qualified companies may place orders on NET 30 terms by Purchase Order. Order By email: [email protected] Order by Fax: Fax us your order 24 hours a day, 7 days a week: 1-614-258-0840 Have Questions? National Azon Equipment Customer Service personnel are available Monday – Friday from 8:00 am to 5:00 pm EST Call toll-free: 1-800-260-0839 1148 Rochester Rd., Troy, MI 48083 800-325-5939 FAX 866-318-7323 [email protected] CREDIT APPLICATION Date______________________ Phone (_____)____________________ Fax (_____)_______________________ Company Name___________________________________________________________________________________ Address__________________________________________________________________________________________ City_____________________________________________ State___________________ Zip_____________________ Owner/Office/Partners Full Name(s)___________________________________________________________________ Company is: Corporation Partnership Individual If corporation, which state incorporated in ______________ Billing Address___________________________________________________ D&B#___________________________ City_____________________________________________ State___________________ Zip_____________________ Years in Business:____________________ Email:_______________________________________________________ Type of Business (products sold/services rendered)_______________________________________________________ TRADE REFERENCES Business__________________________________________________ Phone (_____)________________________ Address___________________________________________________ Fax (_____)_________________________ Business__________________________________________________ Phone (_____)________________________ Address___________________________________________________ Fax (_____)_________________________ Business__________________________________________________ Phone (_____)________________________ Address___________________________________________________ Fax (_____)_________________________ BANK REFERENCE Bank Name_______________________________________________ Phone (_____)_________________________ Address___________________________________________________ Fax (_____)__________________________ Contact _______________________________________________ Acct. #_________________________________ Is your Company: If Non-Taxable: Taxable Exempt Non-Taxable Resale Government Industrial Processing Out of State Federal I.D. #:___________________________ Sales Tax Exemption #:______________________ Terms: Net 30 days. Signature __________________________________ Minimum Order: $500.00 net Name______________________________ (Please note that customer is responsible for reimbursing National / AZON for all reasonable legal and/or collection agency fees which it may incur in the event that an account is turned over to collections.) Rev. 12/2010