Your company has placed an order, or is contemplating an order with Phantom Research Laboratories, Inc. To facilitate processing and prompt shipment of your order, please complete and return this application as quickly as possible. The completed form may be emailed to Sales@phantomresearch.com, faxed to (619) 449-7711 or mailed to the address below:


ATTN: Credit Department - New Accounts
Phantom Research Laboratories, Inc.
1957 Friendship Drive, Suite D
El Cajon, CA. 92020 - USA


If the billing address is the same then check this box

Bank reference

Trade references

Reference #1

Reference #2

Reference #3


I (we) understand that all information provided is for the purpose of obtaining credit and such information will be handled in confidence. The undersigned certify the above information is true and correct and agrees to comply with our payment terms of Net 30 days, on approved credit.





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