Business Credit Application[1]

Business Credit Application Business Name: _________________________________ Address: _______________________________________ ______________________________________________ City: _______________________ State: _____________ Zip Code: ______________ Tel. No. _________________ Owner/Manager _________________________________ How long in business ____________ D & B Rated ______ Trade References: 1.) Name: ______________________________________ Address: _______________________________________ ______________________________________________ City: _______________________ State: _____________ Zip Code: ______________ Tel. No. _________________ 2.) Name: ______________________________________ Address: _______________________________________ ______________________________________________ City: _______________________ State: _____________ Zip Code: ______________ Tel. No. _________________ 3.) Name: ______________________________________ Address: _______________________________________ ______________________________________________ City: _______________________ State: _____________ Zip Code: ______________ Tel. No. _________________ 4.) Name: ______________________________________ Address: _______________________________________ ______________________________________________ City: _______________________ State: _____________ Zip Code: ______________ Tel. No. _________________ Bank References: 1.) Name: ______________________________________ Address: _______________________________________ ______________________________________________ City: _______________________ State: _____________ Zip Code: ______________ Tel. No. _________________ 2.) Name: ______________________________________ Address: _______________________________________ ______________________________________________ City: _______________________ State: _____________ Zip Code: ______________ Tel. No. _________________ Credit line requested $_____________________________ Pending lawsuits against Company: __________________ The undersigned authorizes inquiry as to credit information. We further acknowledge that credit privileges, if granted, may be withdrawn at any time. ______________________________ [clearly print name after signature]