Credit Application

Fill in your information

 
Date:


________________________________________________
Complete Name of Firm:


________________________________________________
Mailing Address:


________________________________________________
City/State:


________________________________________________
Street Address (if different):


________________________________________________
Phone:


______________________ Fax:______________________
Email:


________________________________________________
How many years at this location:


___________ Is building owned or rented?_____________
Kind of business:


________________________________________________
SIC Code:


__________________________ Partnership: ___________
Individual Owner:


________________________________________________
Corporation:


________________________________________________



Years Established: ______ Incorporated?_____When? _______Where? ______________
Name(s) of Officer(s)
or Owner(s):


________________________________________________
Federal Tax ID #
(or SSN of Owner if Private):


________________________________________________
Website:


________________________________________________
Name and Address of Bank:


________________________________________________
Bank Officer:


________________________________________________
Account #:


________________________________________________




Authorized Buyers on this Account: ____________________________________________

Are Purchase Orders Required? Yes _______   No _______ 

 

This is an Account Application for parts only. All engine purchases are to be prepaid prior to shipment.

 

CREDIT REFERENCES

1. Company Name:


________________________________________________
Address:


________________________________________________
City/State:


________________________________________________
Phone:


_____________________ Fax:_____________________

 

2. Company Name:


________________________________________________
Address:


________________________________________________
City/State:


________________________________________________
Phone:


_____________________ Fax:______________________




3. Company Name:


________________________________________________
Address:


________________________________________________
City/State:


________________________________________________
Phone:


_____________________ Fax:______________________

The undersigned official, to induce the granting of credit to the above firm, hereby personally guarantees the Company’s credit.


Signature & Title of Corporate Officer: _________________________________________

AttachmentSize
FoleyCreditApplication.pdf54.22 KB