Shine Bimetal Precision Bi-Metal Since 1998

P.O. Box 7352
Clearwater, FL 33758
1-800-710-1050
info@shinebimetal.com

New Account Application

Complete and sign below to open a trade account with Shine Bimetal LLC. We review all applications within one business day.

— 01

Business Information

Tell us about your business. All fields marked with an asterisk are required.

Company / Full Name *

Physical Address *

Shipping Address (if different)

City *

State *

Zip / Postal Code *

Business Phone *

Fax

Email *

Type of Organization *

Years in Business

Tax ID #

SSN # (sole proprietorship only)

Type of Business / Industry *

Are precious metals essential to the business? *

Yes No

Please explain

— 02

Bi-Metal Usage

Estimated annual and initial order quantities help us prepare your account.

Annual use — 18kt gold bi-metal (ounces)

Annual use — 22kt gold bi-metal (ounces)

Initial order — 18kt gold bi-metal (ounces)

— 03

Principals or Owners

Names and titles of business principals.

Name

Title

Name

Title

— 04

Trade References

Please provide up to three trade references.

Reference 1

Company Name

Contact Person

Phone

Reference 2

Company Name

Contact Person

Phone

Reference 3

Company Name

Contact Person

Phone

— 05

Order Contact

Name of person placing orders *

Phone *

— 06

Certification & Signature

I certify that the information provided above is true and correct. By signing below, I agree that this electronic signature constitutes my legal signature on this application and that I am authorized to apply for a trade account on behalf of the above-named business.

Full Legal Name *

Email Address *

Draw Signature

Type Signature

Use your mouse, touchscreen, or type your name

I agree that I am ___________ and this is a legal representation of my signature, with the same validity as a pen-and-paper signature, for all purposes related to this trade account application with Shine Bimetal LLC.

A signed PDF copy will be generated for your records and emailed to Shine Bimetal for review.

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New Account Application

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