Credit Application

Credit Application

Name of Business

Date

Address

Phone

Email

City

State

Zip

Nature of Businnes

Date Established

Resale Tax or Permit No.

Type of Business

Corporation

Partnership

Individual Ownership

Names of Owners or Officers

President

Vice President

Secretary

Treasurer

We estimate our monthly credit requirements from your firm to be:

Bank Info

Bank Name

Phone

Address

Zip Code

Person to Contact

Type of Account

Checking Account

Authorized Signature

Title