Mid-America Packaging

New Accounts

At MAP Application Equipment we have one goal …

To be the most responsive equipment supplier in the business. Below is our credit application form. Please fill this out this form to prepare for your first order with us. Please also follow the instructions below to submit your W9 and tax exempt information to NewAccountSetup@ajadhesives.com.

We appreciate your business.

Confidential Credit Application

"*" indicates required fields

Name as listed on W9
Doing Business As
Billing Address*
Ship To Address*
Company Is*

Accounts Payable Information

Direct If Available

Purchasing Information

Direct if available.

Bank Information

Bank Address:*
Credit Terms are 30 days from date of invoice. With my signature below or submission of my own credit form I am authorizing the release of any credit information for the completion of this credit application and I certify the information provided above or attached is correct. The undersigned agrees to pay all collection costs, court costs, and legal fees incurred to collect delinquent balances.
Date*

What to do next:

After submitting this form, submit company W-9, tax exempt letter/certificate or resell permit to NewAccountSetup@ajadhesives.com