• New Customer?

Jutzi Water

Credit Application.

If you do not have an existing account with Jutzi Water Technologies, you will first need to fill out our credit application. The form below can be filled out and submitted electronically or you may print it out, fill it out by hand and deliver to our office.

Jutzi Water Credit Application

*indicate mandatory fields

BANKING INFORMATION

CREDIT INFORMATION

CREDIT REFERENCES

APPLICANT’S INFORMATION

Terms of sale, including terms of payment and charges, for each purchase are agreed to be those specified on the face of each invoice. Interest is calculated at 2% per month or at 25% per annum for past due accounts. The customer hereby agrees to pay all costs of collection or legal fees should such action be necessary due to non-payment. Authorization is hereby given to Jutzi Water Technologies to obtain such credit information and reports regarding the undersigned from others as permitted by law.

4 + 3 = ?

Email or Fax Your Form

If you’ve completed the hard copy version of our form, it can be delivered to our office at:

P.O. Box 280
279 Lorne Avenue, East
Stratford, ON    N5A 6T1
Fax: 519-814-9288

Have Questions? Contact Us!

If you have any issues or questions regarding the form, please feel free to contact our office through our email form located on our Contact Page or call us between 8:00 AM and 5:00 PM at either of these numbers:

Local: 519-814-WATER (9283)
Toll-Free: 1-833-299-WATER (9283)

Mission Statement.

Do our best.
Do what’s right.
Treat others as we’d like to be treated ourselves.