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APPLY FOR CREDIT AT SITE PRO 1
Company Name:
Address:
Accts Payable Contact
Phone #:
Fax #:
E-Mail:
Years in business under this name:
Date:
Type of Business:
Please select one
------------------------------
Corporation
Partnership
Sole Ownership
Credit line requested:
BANK REFERENCES
Bank Name :
Address:
Account Numbers:
Checking:
Savings:
Loan:
Phone:
TRADE REFERENCES (THREE REQUIRED)
1:
Company Name:
Address:
Contact:
Phone:
Fax:
Account#:
2:
Company Name:
Address:
Contact:
Phone:
Fax:
Account#:
3:
Company Name:
Address:
Contact:
Phone:
Fax:
Account#:
All statements made herein are true and accurate to the best of our knowledge. We agree that if Site Pro 1, Inc. has to take action to collect our debt, we will pay for the costs of collection. We authorize Site Pro 1, Inc. to make any and all inquiries necessary for action on this credit application. We hereby indemnify the above company from any liability resulting from this credit survey.
Name:
Initial:
Date:
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