STEP 3 - Authorization to Release Credit Information

Please fill out, click display, print, sign and fax this form to: (800) 767-9722 before proceeding to Step 4.

In connection with a request for an open account with ACM Technologies I hear by authorize you to
release information to ACM Technologies regarding credit history, checking and savings accounts
and/or loan experience.


Company Name:

Applicants Name:

Address:
City/State/Zip:
Date:
 


Yes, I accept the conditions in the ACM User Agreement.

 

Applicants Signature:_______________________   Date:_______________

ACM understands that this information will be kept in the strictest confidence between your organization and ACM Technologies, Inc.

Please click Print and Sign this page before continuing to Step 4

Clicking Display will not send any information. It will only change the appearance of the form in order to print.