Credit Application Form Template

November 30, 2009

in Application Forms

Credit application form is used by companies to determine whether they are going to offer credit services to prospective clients or not. Portraying that you have a good credit history will help you in getting credit. However, you should not falsify information so as to get credit.

The undersigned is applying for credit with (Name of company) ______________

Name of company: _________________________________________________

Address: _________________________________________________________

Telephone no: ___________________ Fax: _____________________________

E-mail: __________________________________________________________

Social security ID: _________________________________________________

VAT no. ________________________________________________________

Type of business: __________________________________________________

Date business was established: _______________________________________

Which state was the business established in? _______________________________

No of Employees: _________________________________________________

What products will you purchase with the credit? _________________________

________________________________________________________________

________________________________________________________________

Amount of credit requested for: $______________________________________

________________________________________________________________

Have you or any of your affiliates had credit from us before?

Yes________

No_________

If yes, under whose name? __________________________________________

________________________________________________________________

Name of person acting on your behalf: _________________________________

_________________________________________________________________

Telephone: _______________________________________________________

REFERENCES

Name and address of referee 1: ________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Name and address of referee 2: ________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

BANK REFERENCE

Account no: ___________________________________________________

Bank/branch: __________________________________________________

Address: ______________________________________________________

_____________________________________________________________

Telephone no: __________________________________________________

SIGNATORY

Signature: (by an authorized signatory): _______________________________

Position: _______________________________________________________

Date: __________________________________________________________

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