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Open Account Credit Application - Legal Forms

Open Account Credit Application Form. This is a Legal Forms form and can be used in Credit And Collection .
 Fillable word Last Modified 5/9/2001
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OPEN ACCOUNT CREDIT APPLICATION Business Name: _____________________________________________________ Billing Address: _____________________________________________________ _____________________________________________________ Shipping Address: _____________________________________________________ _____________________________________________________ Phone: _____________________ Fax: ________________________ Name of Parent Co. ( If Subsidiary ): ___________________________________ Type of Business: ( ) Individual ( ) Partnership ( ) Corporation Number of Years in Business: ______ Federal Tax Number: __________________ Social Security Number: _________________ PROPRIETOR, PARTNERS OR OFFICERS Name: _________________________________ Title: ______________________ Home Address: _____________________________________________________ Phone: ___________________________ Name: _________________________________ Title: ______________________ Home Address: _____________________________________________________ BANK REFERENCE Name: _________________________________ Account Number: __________________ Address: ___________________________________ Phone: ______________________ 2001 © American LegalNet, Inc. TRADE REFERENCES Name: _________________________________ Phone: __________________ Address: ___________________________________ Contact : ______________________ Name: _________________________________ Phone: __________________ Address: ___________________________________ Contact : ______________________ INDIVIDUAL RESPONSIBLE FOR PAYMENT OF ACCOUNT Name: _________________________________ Title: ______________________ The above information is for the purpose of obtaining credit and is warranted to be true. I/We hereby authorize the firm to whom the application is made to investigate the references listed pertaining to my/our credit and financial responsibility. Business Name: _____________________________________________ Authorized Signature: _______________________ Date: _____________ 2001 © American LegalNet, Inc.
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