Business credit application form

Business Name__________________________________Date______________ Address______________________City__________State_________Zip_____ Owner/Manager_______________________________Tel.No.______________ How long in business________________________D & B Rated__________ Trade References: Name_______________________________Address_______________________ Name_______________________________Address_______________________ Name_______________________________Address_______________________ Name_______________________________Address_______________________ Bank References: Name_______________________________Address_______________________ Name_______________________________Address_______________________ Credit line requested $_________________________________ Pending lawsuits against Company: ___________________________________________________ ___________________________________________________ ___________________________________________________ The undersigned authorizes inquiry as to credit information. We further acknowledge that credit privileges, if granted, may be withdrawn at any time. _______________________________