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Application for Credit

Please fill out the below form in its entirety to be considered for a credit approval. Our credit manager will notify you of your approval in a timely manner. All information provided will be held in strictest confidence.

FIRM INFORMATION




OWNERSHIP

CorporationPartnershipIndividualIncorporated in past 12 months






FINANCES




REFERENCES

Are cash sales okay until credit is approved?
YesNo



We certify that all the information on this form is correct. We fully understand your credit terms and agree to the proper payment in consideration of extended credit.

Electronic signature: