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dicks sport

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									                                               Dicks Sporting Goods.com
                                         CORPORATE CREDIT APPLICATION
                      (not for use in connection with sales to individuals or in connection with installment sales)

                                                                                    FOR INTERNAL USE: NEW/UPDATE
                                                                                    Customer Number:
                                                                                    Credit Limit Amount:
                                                                                    Approved By:         Date:

Co mpany/Organization Name (“Buyer”):
DBA:                                                    Website/URL:                                            Phone:
Street:                                                         City:                                 State:             Zip:

Name of Purchaser:                                                                           Title:
Phone:                               Fax:                                  Email:

Type of Ownership: • Sole Proprietorship • Partnership • Corporation • Other

           Name              % Ownership                          Home Address                                 Phone            SSN#




Accounts Payable Contact:                                                                    Title:
Phone:                               Fax:                                 Email:

Year Business Started:                      Any Prior Bankruptcies:
Listed w/ D&B: • yes • no                   D&B Number:
Tax Exempt Certificate ID# (if applicable):                                (Please Attach Tax Exempt Certificate)

BANK REFERENCES
Name of Bank:
Street:                                                         City:                                 State:             Zip:
Type of Account: • Checking • Savings        Account Number:
Contact:                                                                            Phone:                      Fax:

Name of Bank:
Street:                                                                  City:                        State:             Zip:
Type of Account: • Checking • Savings        Account Number:
Contact:                                                                            Phone:                      Fax:

TRADE REFERENCES (OPEN ACCOUNTS ONLY)
Company Name:                                                                              Account Number:
Street:                                                                  City:                     State:                Zip:
Contact:                                                                            Phone:                Fax:

Company Name:                                                                              Account Number:
Street:                                                                  City:                     State:                Zip:
Contact:                                                                            Phone:                Fax:

Company Name:                                                                              Account Number:
Street:                                                                  City:                     State:                Zip:
Contact:                                                                            Phone:                Fax:

I hereby certify that I am a duly authorized agent for Buyer, empowered to sign this Application, and that all information provided in
this Application is true and complete and made for the purpose of obtaining credit. I understand that the acceptance of orders is
conditional on credit approval by Selle r and Buyer’s assent to the attached Terms and Conditions.

                                                                         BUYER:

Date: _________________________                                          By: ____________________________
                                                                             Name:

								
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