BDC Inc.
th
36 West 47 Street. Suite #705 New York, NY 10036
Phone: 212-840-6999 Fax: 212-840-9298
Application For Credit Date: _______________
For the purpose of obtaining merchandise from you on credit, we submit the following information and
authorize you to contact the references given.
Firm Name____________________________ Tel: ____________________ Fax: ____________________
Address__________________________________ City___________________ State _______ Zip ________
Proprietorship_______ Partnership_______ Corporation_______ Other _______
Year Established_______________ At Present location since (date)______________
Bank_________________ Contact _________________ Account No._______________ Tel: ____________
Address_____________________________ City_________________ State________ Zip _________
Credit References
Name_____________________________ Tel: ____________________ Fax: __________________
Address_______________________________ City ______________ State_______ Zip _________
Name_____________________________ Tel: ____________________ Fax: __________________
Address_______________________________ City ______________ State_______ Zip _________
Name_____________________________ Tel: ____________________ Fax: __________________
Address_______________________________ City ______________ State_______ Zip _________
Name_____________________________ Tel: ____________________ Fax: __________________
Address_______________________________ City ______________ State_______ Zip _________
I, ______________________ Guarantee the payment of all sums that_________________________
(Hereafter called “the company”) now or hereafter owe BDC Inc.
Should the company default in payment of any sums due and payable to BDC Inc. I agree to pay BDC
Inc. all such sums.
I agree that my liability under this guarantee shall not be affected by any change in terms of payment
from the company to BDC Inc.
Signature of Guarantor__________________ Print_______________________ Dated__________________
Home Address____________________________________________ Home Phone____________________
Please print clearly. Thank you for your cooperation!