A credit application form is used by creditors to gather information from credit recipients. As the recipient, you are required to disclose information about your company to your potential creditors. Trade references will be looked up, therefore be sure to put down only names of referees you are sure will give you good references.
To: ___________________________ Address: ______________________
Date: __________________________ Telephone: ______________________
Fax: _____________________________
COMPANY INFORMATION
Business name: _________________________________________________________
Trading name: ___________________________________________________________
Address: _____________________________ Zip ____________City _____________
Telephone: ______________________________________________________________
Fax: _________________________ Date founded: ______________________________
Tax ID no ___________________ Estimated annual sales: ______________________
How long have you traded at this address? ______________________________________
Trades Referees (where you have applied for credit before)
Name of company ———————————————–
Address ———————————————————–
Telephone———————————————————
BANK
Name: _________________________ Branch: ___________________________
Contact person: ___________________________Telephone no.____________________
Designation: _______________________________
Account no. ________________________________
CREDIT APPLIED FOR
How much are you applying for: $ __________________________________________
________________________________________________________________________
Please tick the box if you agree with the following statements:
?
The applicant:
Agrees to pay the credit due and any costs incurred due to the collection of the credit, including legal fees and will submit financial statements if requested to
Any other comments _____________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Date: _________________________ Signature: _______________________
Title: __________________________________________________________
Name: _________________________________________________________
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