Brewer Sewing Supplies
3800 W. 42nd StreetChicago, IL 60632
Customer/Credit Application
Expected Monthly Purchases $Estimated Amount of Opening Order $
Name of Business (Customer)
Phone No. ( )Legal Name of Corporation (if different)Fax No. ( )Name and Address of Parent Company (if any)Billing AddressCityStateZipShipping Address (if different)CityStateZipWho will be placing orders?Email Address:Who should we contact with bookkeeping questions?Email Address:
Which catalog do you wish to receive ($5.00 per catalog)?
Notions
Parts
Both
Form of Business
Sole ProprietorshipFederal Employer ID No.
PartnershipDate Business Started
CorporationState of Incorporation Date of Inc.
Type of Business (please check all that apply)
Sewing Machines
Sewing Machines & Vacuums
Sewing Machine Repair
Notions
Fabric
Quilting
Crafts
OtherArea business is located in (please check one)
Residential
Business District
Sales Tax I.D. #Duns #(Please include photo copy of Tax I.D.)Names of All Owners, Partners, or OfficersTitleResident AddressSocial Security No.Phone
Are you currently underbankruptcy protection?
Yes
No
Bank Reference
Name of BankStreetCity, State, ZipChecking Account NumberLoan NumberBank Officer (reference)Phone Number ( )
PLEASE ATTACH RECENT FINANCIAL STATEMENTTrade References (list primary vendors only)
1.NameStreetCity, State, ZipAcct. NumberPhone ( )2.NameStreetCity, State, ZipAcct. NumberPhone ( )3.NameStreetCity, State, ZipAcct. NumberPhone ( )
Please fill out and sign the back side of this form.Failure to sign back side or provide complete reference information (if applying for credit) will delay processing.Please send original signed copy to: Brewer Sewing Supplies 3800 W. 42nd Street Chicago, IL 60632
Are there any judgements or suitspending against your company?
Yes
No
If Applying for Credit, Please Fill Out the Following:
Please Complete Other Side
Salesman Name:Salesman #:
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