If you already have a credit application filled out, please attach at the end of this form
If at the above bank for less than six (6) months, provide bank name, phone number, and account number below.
Terms of sale have been fully explained and I understand that if an account is established, my credit line is subject to periodic review. Also, shipments may be held if my account is delinquent or exceeds the established line of credit. In order to expedite the opening of your new account, please provide as much information as possible. I understand the above information is given in confidence for the sole purpose of establishing an open account. I further certify that the facts provided by me for this purpose are true and exact
By signing, you are personally guaranteeing payment of a balance due on your account
Due to the frequency of banks refusing to provide data without written authorization from their client, we request that you complete the following. Your cooperation will expedite processing your account.