Made By Man Diamonds :: Credit Application

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MBM Diamonds LLC is in full compliance with the USA Patriot Act and its Anti Money Laundering provision. MBM Diamonds LLC does not sell to the general public. You will be asked to provide a government issued identification number such as your Federal Tax ID #, Social Security #, state issued driver’s license, passport, or state issued ID card. All information submitted will be held in strict confidence. This is for the protection of MBM Diamonds LLC as well as our customers.

Company Name

President, CEO or Partners

Business Structure *

Corporation

Partnership

Sole Proprietorship

Telephone

( ) - *

Fax

( ) -

Billing Address *

Shipping Address * Same as billing address

Your Name

Website

In order to comply with our legal obligations under the USA Patriot Act and Anti Money Laundering laws we ask you to provide the information below. For your protection and ours, we encourage all of our customers and suppliers to adopt and implement anti-corruption measures.

You must provide either your Federal Tax ID or your Social Security Number. We do not require both.

Federal Tax Id

Social Security #

Do you maintain an AML program? *

Yes

AML Compliance Officer

Bank Name

Account number

Jewelry Trade Reference(s)

The material we supply is free of conflict materials. It is not sourced from entities that engage in unfair or deceptive purchasing practices or sourced from e-waste recycling facilities that do not have an environmental policy.

By checking this box, I certify that my business does not engage in deceptive or unfair purchasing practices. *

To complete the application process, you MUST provide a copy of your business license.
You may upload it below, email it to info@mbmdiamonds.com

* Required Fields