[Place your logo

and business details here]

Example customer credit application for trade

account
Business contact information
Contact name:
Phone: Fax: E-mail:
Address:
City: State: Postcode:
In business since:
Sole trader:  Partnership:  Limited liability:  Other: 
Business and credit information
Postal address:
City: State: Postcode:
Telephone: Fax: E-mail:
Bank name:
Bank address: Phone:
City: State Postcode:
Business/trade references
Company name: Company name:
Contact name: Contact name:
Address: Address:
City: Postcode: City: Postcode:
Phone: Phone:
Fax: Fax:
E-mail: E-mail:
Company name: Company name:
Contact name: Contact name:
Address: Address:
City: Postcode: City: Postcode:
Phone: Phone:
Fax: Fax:
E-mail: E-mail:
Agreement
1. All invoices are to be paid on the 20 th of the month following the date of the invoice.
2. Any claims arising from invoices must be made within seven working days of receipt of invoice.
3. By submitting this application, you authorise [Enter your company name here] to make inquiries
into the banking and business/trade references that you have supplied.

Signatures

Title: Title:

Date: Date:
Please note that this is a guide only and should neither replace competent advice, nor be taken, or relied upon, as
financial or professional advice. Seek professional advice before making any decision that could affect your
business.

Here is a sample credit application that can serve as a guide:

 [Place your logo
and business details here]
Company Name:

Contact Name:

Title:

Address:

Phone:

Fax:

Email:

Date:

We are interested in establishing an open account with your company and request that you
consider this application. Please find the following information for our company:

Type of Business:

Number of Years in Business:

Federal Tax ID#:

Annual Sales:

Bank References:

Bank Name:

Contact Name:

Phone:

Fax:

Account Number:

Trade References:

Company Name:

Contact Name:

Phone:
 [Place your logo
and business details here]
Fax:

Account Number:

Company Name:

Contact Name:

Phone:

Fax:

Account Number:

Please send invoices to:

Contact Name:

Title:

Address:

Phone:

Fax:

Email:

Payment terms are net 30 days. Our company agrees to pay all collection and/or attorney fees
resulting from default on payment.

By signing below, I certify that the information provided in this application is accurate and
complete.

Sincerely,

[Your Name] [Title] [Company Name]

Authorized Signature: Date: