Business Credit Application Sample and Format
| CONTACT INFORMATION | ||||
| YOUR NAME | TITLE | |||
| PHONE | ||||
| BUSINESS INFORMATION AS REGISTERED | ||||
| COMPANY NAME | ||||
| ADDRESS | PHONE | |||
| CITY | STATE | ZIP CODE | ||
| LENGTH OF TIME AT CURRENT ADDRESS: ______ YEARS ______ MONTHS | ||||
| TYPE OF BUSINESS : SOLE PROPRIETORSHIP | PARTNERSHIP | LLC | CORPORTATION | OTHER | ||||
| BANK INFORMATION | ||||
| BANK NAME | CONTACT NAME | |||
| ADDRESS | PHONE | |||
| CITY | STATE | ZIP CODE | ||
| TYPE OF ACCOUNT | ACCOUNT NUMBER | |||
| SAVINGS | ||||
| CHECKING | ||||
| OTHER | ||||
| BUSINESS REFERENCES | ||||
| Please provide us at least three other companies your business has established credit with previously | ||||
| 1 | COMPANY | CONTACT NAME | |||
| PHONE | ||||
| ADDRESS | TITLE | |||
| CITY | STATE | ZIP CODE | ||
| COMMENTS | ||||
| 2 | COMPANY | CONTACT NAME | |||
| PHONE | ||||
| ADDRESS | TITLE | |||
| CITY | STATE | ZIP CODE | ||
| COMMENTS | ||||
| Continue on to next page … |
PAGE 1 OF 2 |
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| BUSINESS REFERENCES | ||||
| Continued from previous page … | ||||
| 3 | COMPANY | CONTACT NAME | |||
| PHONE | ||||
| ADDRESS | TITLE | |||
| CITY | STATE | ZIP CODE | ||
| COMMENTS | ||||
| 4 | COMPANY | CONTACT NAME | |||
| PHONE | ||||
| ADDRESS | TITLE | |||
| CITY | STATE | ZIP CODE | ||
| COMMENTS | ||||
| CREDIT AGREEMENT | ||||
|
1 | All invoices must be paid within 30 days of the date issued 2 | Any claims regarding an invoice issued must be made within 7 days of the date issued 3 | You authorize inquiry into the banking and business references provided within this application
|
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| COMPANY REPRESENTATIVES | ||||
| 1 | SIGNATURE | TITLE | |||
| NAME | DATE | |||
| 2 | SIGNATURE | TITLE | |||
| NAME | DATE | |||
| NOTES & COMMENTS | ||||
|
PAGE 2 OF 2 |
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—————————————————
Business Credit Application Form
COMPANY DETAILS
Name of business: _______________________________________________
Address: _______________________________________________________
Telephone: ________________________ Fax: _________________________
Contact person: ___________________________________________________
Social security No: ________________________________________________
Date when the business was started: _______________________________________
What type of business are you into?
Partnership ____________________
Corporation ____________________
Sole Proprietorship______________
Other ____________________
If you are a Sole Proprietorship, are you tax exempt?
Yes ________
No_________
Amount of money you are requesting for: ______________________________________
________________________________________________________________________
REFERENCES
Referee 1: Name: _________________________________________________________
Telephone: _____________________________________________________
Address: _______________________________________________________
Referee 2: Name: _________________________________________________________
Telephone: _____________________________________________________
Address: _______________________________________________________
Referee 3: Name: _________________________________________________________
Telephone: _____________________________________________________
Address: _______________________________________________________
Bank references
Name of bank 1: ___________________________ Branch: ______________________
Contact person: ________________________________________________________
Account no: ________________________________ Telephone no._________________
Name of bank 2: ___________________________ Branch: ______________________
Contact person: ________________________________________________________
Account no: ________________________________ Telephone no._________________
Are there any pending lawsuits against the company? ______________________________________________________________________
_______________________________________________________________________
I 24 hour cialis have read and understood the terms and conditions
Name: _____________________________ Signature: __________________________
Date: _____________________________
——————————————————————-
Sample Credit Application for a Business Account

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Business Credit Application Sample
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] Source
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