Business Credit Application

Business Name_______________________ Date__________

Address________________________ City______________

State______ Zip Code_________

Owner/Manager_______________________Tel. No.__________________

How long in business____________

 

Trade References:

Name____________________Address_____________________________

Name____________________Address_____________________________

Name____________________Address_____________________________

Name____________________Address_____________________________

Credit line requested $_________________

Pending lawsuits against Company:

____________________

____________________

____________________

 

The undersigned authorizes inquiry as to credit information. We further acknowledge that credit privileges, if granted, may be withdrawn at any time.

__________________________________

 

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