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Credit Application: Incomplete Applications Will Not Be Processed

This document is a credit application form requesting information such as the applicant's legal name, address, phone numbers, bank references, other business references, and signature to process a credit application. The form notes that incomplete applications will not be processed and that payment terms are net 30 days.

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Anonymous P8Bt46mk5I
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© © All Rights Reserved
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99 views1 page

Credit Application: Incomplete Applications Will Not Be Processed

This document is a credit application form requesting information such as the applicant's legal name, address, phone numbers, bank references, other business references, and signature to process a credit application. The form notes that incomplete applications will not be processed and that payment terms are net 30 days.

Uploaded by

Anonymous P8Bt46mk5I
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CREDIT APPLICATION

APPLICATION WILL NOT BE PROCESSED WITHOUT PURCHASE ORDER

INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED

Date
Legal Corporation Name ________________________________________________________________
POB # ________________________________________________ Zip ____________________________
Street ___________________________________ City __________________ State ___ ___ Zip __ _______
Phone ___________________________________ Fax _____________________________________
Corporation: ( ) Yes ( ) No Type _________________________ State _________________
Dunn & Bradstreet Number ___________ _____ E-mail _______________________________________

A/P Contact Name:_________________ _____ A/P e-mail:_____________________________


A/P Phone:______________________________ A/P Fax:_______________________________

Bank References:
Institution _____________________________________________________________________
Street ______________________________________ City ____ __________ St ______ Zip ___________
Contact _________________________________ Phone ___________________ Fax ________________
Account No’s: Checking ________________________ Savings _________________________Loan(s)

Other References (fax numbers or emails must be provided):


Co. Name ________________________________ Co. Name ___________________________________
Street ___________________________________ Street _______________________________________
City, State, Zip ____________________________ City, State, Zip ________________________________
Phone ___________________________________ Phone _______________________________________
Fax/Email_____________________________ Fax/Email ___________________________________

Co. Name ________________________________ Co. Name ____________________________________


Street ___________________________________ Street _______________________________________
City, State, Zip ____________________________ City, State, Zip ________________________________
Phone ___________________________________ Phone _______________________________________
Fax/Email_______________________________ Fax/Email___________________________________
Please provide Sales & Use Tax Exemption Certificate

**Signature** Print Name & Title Date

**PAYMENT TERMS ARE NET 30 DAYS**

FOR HMC USE ONLY:


Credit Limit Assigned ___________ Acct# Approved _________________________ Date_______________

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