Credit Application Form

Business Contact Information

Title:
Company name:
Phone: Fax: E-mail:
Registered company address:
City: State: ZIP Code:
Date business commenced:
Sole proprietorship: Partnership: Corporation: Other:

Business and Credit Information

Primary business address:
City: State: ZIP Code:
How long at current address?
Telephone: Fax: E-mail:
Bank name:
Bank address: Phone:
City: State: ZIP Code:
Type of account: Account Number:
 

Business/trade references

Company name:
Address:
City: State: ZIP Code:
Phone: Fax: E-mail:
Type of account:
Company name:
Address:
City: State: ZIP Code:
Phone: Fax: E-mail:
Type of account:
Company name:
Address:
City: State: ZIP Code:
Phone: Fax: E-mail:
Type of account:
Agreement
  1. All invoices are to be paid 30 days from the date of the invoice.
  2. Claims arising from invoices must be made within seven working days.
  3. By submitting this application, you authorize Edge of Arlington to make inquiries into the banking and business/trade references that you have supplied.
  4. By giving Edge of Arlington credit card information, we reserve the right to apply any past due balances to this card.
  5. Please fax back to 817-795-6651 or email to eoasaw@mindspring.com

Signatures

Title:
Date:
Title:
Date:
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