Credit Application

CONTACT INFORMATION:
Company Name Address
City State
Zip
Organization Parent Organization (If applicable)
Type of Business Years in Business
OFFICER AND KEY EMPLOYEES:
President
Chief Financial Officer
Transportation Manager
Accounts Payable Contact Phone
TRADE REFERENCES:
Company Contact
Address Phone
Company Contact
Address Phone
Company Contact
Address Phone
Signed Date
Title
NOTE: PAYMENTS ARE DUE 15 TO 30 DAYS TO MAINTAIN AN OPEN ACCOUNT
CREDIT AUTHORIZED