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BILLING INFORMATION
GENERAL INFORMATION
INVOICING INSTRUCTIONS
TRADE REFERENCES (OR ATTACH INFORMATION SHEET)
*Upload your trade reference sheet here or complete the section below.
Terms and Conditions: Completion of this credit application constitutes Applicant’s acceptance of Seller’s Terms and Conditions of sale, as set forth on the sellers website (www.nanotechenergy.com) and incorporated herein by reference. Applicant authorizes Nanotech Energy, Inc. to obtain credit and financial information concerning the Applicant at any time and from any source. The undersigned warrants that the above agreement has been carefully read and that the Applicant understands completely.