CREDIT APPLICATION (COMMERCIAL)

Date:

Business name:

Type of business:

Trade name (if different):

Address:                            City:

State:                              Zip:

Telephone:         Owner/President:[name]

How long in business:    Credit rating:

Trade references (names and addresses):

Bank references (include account numbers & addresses):

Location of financial statements:    

Notice:

The undersigned authorizes an inquiry as to the credit

information of the business. In addition, credit if granted may

be withdrawn at any time. I certify the above information to be

true.

____________________________

Owner/President