Seaqua Deli is the best Deli on the Island, bar none!

Seaqua Delicatessen
 4250 Jerusalem Ave.
Massapequa, New York 11758
516-799-5600 PH
516-799-5639 FX

Credit Application Form; Seaqua Delicatessen Caterers

When finished; print out completed form, sign, and FAX it to (516) 799-5639.

Company Name

Contact Person

Contact Phone

Contact FAX

Contact E-Mail

Address and Suite

State

ZIP

Date Business Established

Bank Name

Branch Address

Branch State

Branch ZIP

Branch Phone

Trade Reference 1

Reference Phone

Trade Reference 2

Reference Phone

Trade Reference 3

Reference Phone

Tax Exempt Y/N (If Yes, please attach copy of Tax Exempt Certificate)

Statement of Trade Terms

 The purchaser agrees to pay Seaqua Delicatessen all sums due pursuant to the terms and conditions herein on any invoice rendered to the purchaser. Payment to be made directly to the store where product was ordered. Once a corporate account has been established the terms are 30 days net. Penalties and interest will accrue after 90 days. Interest is accrued at a rate of 18% annually.

Accepted By; _________________________________            Print Name _________________________________




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