Credit Application

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Credit Application

Complete the form below to apply for a Net Terms account with Mouser Electronics. Please contact japan.credit@mouser.com for any questions or assistance.

Trade References (3 Trade References Preferred)

Reference 1 (Required) *

Company Name *

Country *

Prefecture *

City *

Postal Code *

Address Line 1 *

Address Line 2

Account Number (If known)

Phone *

Fax

Email Address *

Reference 2 (Recommended)

Company Name

Country *

Prefecture *

City *

Postal Code *

Address Line 1 *

Address Line 2

Account Number (If known)

Phone

Fax

Email Address

Reference 3

Company Name

Country *

Prefecture *

City *

Postal Code *

Address Line 1 *

Address Line 2

Account Number (If known)

Phone

Fax

Email Address

Authorization

By submitting this application, I am authorizing a Credit Review and release of banking and/or financial information. I also acknowledge that terms of payment are Credit Card or Prepaid until net terms are approved. Each invoice will be subject to a 1.5% charge per month if not paid according to approved account terms. Should applicant default in payment, Mouser Electronics shall be entitled to additional incurred collection costs and attorney’s fees to the unpaid balance.

Credit reports and Account information: the credit of your business will be used in making credit decisions. You authorize us to investigate the creditworthiness of your business by obtaining credit reports and making other inquiries.

If you would like to find out more about how Mouser handles your personal data, please refer to our Privacy Center for more information.

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Mouser and Mouser Electronics are trademarks of Mouser Electronics, Inc. in the U.S. and/or other countries. All other trademarks are the property of their respective owners. Corporate headquarters and logistics center in Mansfield, Texas USA.

Credit Application

Company Information

Trade References (3 Trade References Preferred)

Authorization