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CUSTOMER CREDIT APPLICATION FORM

For the purpose of establishing credit with your company, the undersigned guarantees the financial information below to be correct and complete to the best of his/her knowledge and authorises any credit investigation needed of the verification of such.

    Type of BusinessSole OwnerPartnershipCorporation

    List three principal suppliers with whom you have maintained credit of a minimum of one year.

    Digital Signature - I hereby agree to the terms, 30 day notice otherwise stated. In the event of collection customer pays all costs and attorney fees.