Please fill in the form below to open a new credit request. The system can also be used to make an observation, in this case please use "Observation only" in the subject roll down and leave the "Amount requested" blank

Company Name:  * 
Full Name:  * 
E-Mail Address:  * 
Telephone:  Ext    
 
Sales Person:  * 
 
Subject:  * 
Invoice Number (1 per credit request):  *    Invoice Date (DD/MM/YYYY):  * 
Amount Requested: .      
Description of the issue: *
Credit Requested for the Following Flowers:
Flower Color Variety Grade Units Unit Price Total Curr Observations

Add Row Freight charges .  
Other .  
Total Credit
Request		 0.00  

Picture(s) (required):  
 
 
 
 
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