Credit Reference Forms - DOC

							                                  YOUR COMPANY LOGO HERE
                                           Address / City / State / Zip

                Phone: (Insert Your Company’s Main Phone) - Fax: (Insert Your Company’s Main Fax)

TRANSMITTAL TO: CREDIT MANAGER                                 RE: CREDIT REFERENCE FOR:
Via FAX or EMAIL:
Company:                                                       Company Name
Address:                                                       Address
City / State / Zip                                             City / State / Zip
Additional                                                     Additional
Information                                                    Information




We are in the process of updating our credit file on the above referenced company. We ask you
in confidence to assist us with the following information:


Products / Services Which Your Company Provides:

Open Account Date:

Terms of Sale:

Average Days to Pay:

Credit Limit:

Current Balance Due:

Past-Due Balance:

Date of Last Purchase:

Date of Last Payment:

Highest Credit Amount:

Payment Experience:               As Agreed                Slow            Extremely Slow

                               Other

Comments:


Thank you in advance for your assistance. This information will be held in confidence.
Please return this form by fax or email to our Credit Department:
Attention: (Your Name, Title & Direct Phone Number)
Fax: (Insert Your Personal Fax Number)
Email: (Insert Your email)