CREDIT APPLICATION FOR A BUSINESS ACCOUNT

BUSINESS CONTACT INFORMATION

Title Company name Phone Fax Registered company address, city, state, zip code City, state, zip code How long at current address? Phone Fax Email Company name Address City ,State, Zip code Account type Company name Address City ,State, Zip code Account type Company name Address City ,State, Zip code Account type Date Business Commenced Sole proprietorship Partnership Corporation Other

BUSINESS & CREDIT INFORMATION

Bank name Primary business address, city, state, zip code Phone Account number Account type

Saving

Checking

Other

BUSINESS / TRADE REFFRENCES

Phone Fax Email Other Phone Fax Email Other Phone Fax Email Other

Saving

Checking

Other

AGREEMENT
1. All invoices to be paid 30 days from the date of invoice. 2. Claim rising invoices must be paid within the seven working after the date of invoice. 3. By submitting application you are authorize [company name] to make inquiries into banking and business/trade references that you have supplied.

SIGNATURE
Signature: Name & Title: Date: Signature: Name & Title: Date: