New Customer Application

 Billing information matches the information provided above

 Purchasing information matches the information provided above

You must fax or email us your state's resale tax form or a completed uniform sales and use tax certificate before we can process your application. Please scan and email it to or fax it to 1-800-877-5391. You will receive a reminder email with this form attached after you submit your application.

Terms and Conditions

Credit, if extended, depends upon the degree of confidence this Credit Application affords.

Applicant agrees to all terms and conditions as stated in the Terms and Conditions. In consideration for the extension of credit by Midland Metal Manufacturing Company, Applicant agrees to pay invoices within terms. Invoices not timely paid will be subject to service charges of 18 percent per annum. Should an account be referred to third parties for collection, Applicant agrees to pay all cost of collecting, including attorney's fees.