Credit Application Form And Personal Guarantee Form
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1
2CREDIT APPLICATION
TERMS NET 30
Please complete and fax this form to our A/R Department at (510) 226-6104
I am being serviced by your
California office
Illinois office
Sales
(Kindly provide representative’s name on right)
Rep ___________________________________
Date ___________________
APPLICATION INFORMATION
Type of Business
Company
D&B
□
Sole Proprietorship
Name ________________________________________________________
No. ________________________
Company
□
Partnership
Address ______________________________________________________
City ________________________
□
Subsidiary
Phone _________________________ Fax ___________________________
State _______ Zip ____________
A/P
A/P
Credit Line
□
Division
Contact ___________________________ Phone/Ext ___________________
Requested $_________________
Sales
□
Employees at this location _______
Total Employees _______
Volume $_______________________
Corporation in state of _____
______
Resale
Years in business under this name _______
Years located at this address _______
Number_ ___________________
□
□
Payment personally guaranteed?
Yes
No
(If yes, please fill out a Personal Guarantee Form)
By _______________________________________________
Title _______________________
OWNERSHIP INFORMATION
Owner
Name
Phone
Fax
Home
Address
City:
State:
Zip:
Owner
Name
Phone
Fax
Home
Address
City:
State:
Zip:
TRADE REFERENCES
Company
Name
Phone
Fax
Address
Account #
Company
Name
Phone
Fax
Address
Account #
Company
Name
Phone
Fax
Address
Account #
BANK REFERENCES
Bank
Name
Phone
Fax
Address
Account #
Bank
Name
Phone
Fax
Address
Account #
A bank authorized signature is required for processing
All Statements made herein are true and accurate to the best of my/our
knowledge.
FIT Bearings is authorized to make any and all necessary
Signature ___________________________________________
inquiries to process this credit application. We hereby indemnify them and
their agents from any liability resulting from this credit review.
Title _______________________________ Date: __________
11/06
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