Fillable Credit Application printable pdf download

CREDIT APPLICATION

COMPANY NAME: _________________________________________________ PHONE: _______________________

STREET ADDRESS: _______________________________________________

FAX: __________________________

CITY: _______________________________________ STATE: ____________

ZIP: ___________________________

BILLING ADDRESS (IF DIFFERENT FROM ABOVE): _____________________________________________________

CITY: ______________________________________

STATE: ____________

ZIP: __________________________

EMAIL: _____________________________________

CREDIT LINE SOUGHT: _______________________________

COMPANY IS A:

CORPORATION

PARTNERSHIP

PROPRIETORSHIP

L.L.C.

P.L.C.

CORPORATE REGISTRATION NO. _______________ V.A.T. NO. ___________ ANNUAL SALES ________________

ARE FINANCIAL STATEMENTS AVAILABLE?

YES

# YEARS IN BUSINESS __________________

COMPANY DIRECTORS/OFFICERS/PRINCIPAL

NAME 1: __________________________________________________________ TITLE: ________________________

HOME ADDRESS: __________________________________________________ PHONE: _______________________

NAME 2: __________________________________________________________ TITLE: ________________________

HOME ADDRESS: __________________________________________________ PHONE: _______________________

NAME 3: __________________________________________________________ TITLE: ________________________

HOME ADDRESS: __________________________________________________ PHONE: _______________________

BANKING DETAILS

BANK NAME: _____________________________________________________ ACCOUNT #: ___________________

BRANCH ADDRESS: __________________________ CITY/STATE/ZIP: _____________________________________

BANK CONTACT NAME: ____________________________________________ PHONE: _______________________

TRADE REFERENCES

VENDOR 1: __________________________________ CONTACT: __________________________________________

PAYMENT ADDRESS: _________________________ CITY/STATE/ZIP: _____________________________________

PHONE: _____________________________________ FAX: ________________ ACCOUNT #: ___________________

VENDOR 2: __________________________________ CONTACT: __________________________________________

PAYMENT ADDRESS: _________________________ CITY/STATE/ZIP: _____________________________________

PHONE: _____________________________________ FAX: ________________ ACCOUNT #: ___________________

VENDOR 3: __________________________________ CONTACT: __________________________________________

PAYMENT ADDRESS: _________________________ CITY/STATE/ZIP: _____________________________________

PHONE: _____________________________________ FAX: ________________ ACCOUNT #: ___________________

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Credit Application