Application for Credit – Silver State Forklift

APPLICATION FOR CREDIT

Company name
Phone
Fax
Physical Address
Street Address City State ZIP Code
Billing Address
Same as previous

Street Address City State ZIP Code
Business type
Business Type
- Owner
- Partnership
- Corporation
Federal I.D. #
Name of Partners / Officers
Title
Name of Partners / Officers
Title
Name of Partners / Officers
Title
Bank
Bank Name
Account Number
Bank Address
Street Address City State ZIP Code
Fax #
Credit References
Name
Street Address Fax # City State ZIP Code
Name
Street Address Fax # City State ZIP Code
Name
Street Address Fax # City State ZIP Code
Name
Street Address Fax # City State ZIP Code
Purchase Order Required?
- YES
- NO
Taxable:
- YES
- NO
Resale #
Signature
Initials
DATE
MM slash DD slash YYYY
TITLE