AcroForm
CreditData.pdf
0821F54AE75532429A33EB591AB3170F
[Company Name] CREDIT APPLICATION FOR A BUSINESS ACCOUNT BUSINESS CONTACT INFORMATION Title Date business commenced Company name Sole proprietorship Phone | Fax Partnership E-mail Corporation Registered company address City, State ZIP Code Other BUSINESS AND CREDIT INFORMATION City, State ZIP Code Bank name: How long at current address? Primary business address City, State ZIP Code Phone Phone Fax Account number E-mail Type of account Savings Checking Other BUSINESS/TRADE REFERENCES Company name Phone Address Fax City, State ZIP Code E-mail Type of account Other Company name Phone Address Fax City, State ZIP Code E-mail Type of account Other Company name Phone Address Fax City, State ZIP Code E-mail Type of account Savings Checking Other Other AGREEMENT 1. All invoices are to be paid 30 days from the date of the invoice. 2. Claims arising from invoices must be made within seven working days. 3. By submitting this application, you authorize [Company Name] to make inquiries into the banking and business/trade references that you have supplied. SIGNATURES Signature Signature Name and Title Name and Title Date Date