Have ready

Legal business name and addresses
Tax ID (EIN) and resale certificate number
Bank name, contact and account number
Three trade references
The name and title of the person authorized to sign

Questions

sales@deepseaatlanticna.com
1 (954) 775-0230

Prefer paper?

Download the PDF application →

Hours

Monday to Friday
7:00 AM to 5:00 PM EST

Business credit application

Four short steps. Fields marked * are required.

Applicant information

Legal business name *

DBA (if applicable)

Billing address *

City / State / Zip *

Shipping address is the same as billing

Shipping address *

City / State / Zip *

Phone *

Accounts payable email *

Website *

Type of business *

Corporation

LLC

Partnership

Sole Proprietor

Years in business *

Tax ID (EIN) *

Resale / Sales tax certificate #

Business contacts

Owner / Officer / Principal

Name *

Title *

Phone *

Name

Title

Phone

Accounts payable contact

Name *

Email *

Phone *

Buyer information

Primary contact(s) authorized to place orders and approve purchases.

Primary buyer

Same as business contact (the owner / officer / principal above)

Name *

Title *

Email *

Phone *

Name

Title

Phone

Banking information

Bank name *

Contact person *

Bank address *

Phone *

Account number *

Trade references

List three current seafood or perishable suppliers preferred, if applicable.

Reference 1

Company

Phone

Reference 2

Company

Phone

Reference 3

Company

Phone

Credit request

Amount of credit requested ($) *

Terms & conditions

By signing below, the applicant certifies that all information provided is true and correct.

Applicant authorizes the above-listed bank and trade references to release credit information.

Applicant agrees to Deep Sea Atlantic NA’s payment terms, including late charges, interest, and any collection fees incurred.

I have read and agree to the terms and conditions above. *Personal guarantee (if required): The undersigned personally guarantees payment of all obligations of the applicant business to Deep Sea Atlantic NA.

Authorization

Authorized signature *

Printed name & title *

Date *

Typing your name acts as your signature on this application.

We use the information in this application to review your credit request and manage your account, as described in our Privacy Policy.

Application received

Thank you. Our team will review your credit application and follow up.

Business credit application.

Business credit application

Applicant information

Business contacts

Buyer information

Banking information

Trade references

Credit request

Terms & conditions

Authorization

Application received