Credit Application
BUSINESS INFORMATION
Company Name: ________________________________________________________
Name:________________________________ Title: _____________________________
Name:________________________________ Title: _____________________________
Address: ________________________________________________________________
City: ____________________________ State: ________ Zip: _________________
Phone: ___________________ FAX: ___________________ Email:________________
Federal ID# ________________ WA State Business Tax Exemption#____________
BANK REFERENCES
Bank Name: ____________________________________________________________
Address: ________________________________________________________________
City: ____________________________ State: ________ Zip: _________________
Account No.: _____________________________________________________________
Phone: ___________________________ Contact: _____________________________
Bank Name: ____________________________________________________________
Address: ________________________________________________________________
City: ____________________________ State: ________ Zip: _________________
Account No.: ____________________________________________________________
Phone: ___________________________ Contact: _____________________________
CREDIT/TRADE REFERENCES
Name: _________________________________________________________________
Address: ________________________________________________________________
City: ____________________________ State: ________ Zip: _________________
Phone: ___________________________ Contact: _____________________________
Name: _____________ ____________________________________________________
Address: ________________________________________________________________
City: ____________________________ State: ________ Zip: _________________
Phone: ___________________________ Contact: _____________________________
Name: _____________ ____________________________________________________
Address: ________________________________________________________________
City: ____________________________ State: ________ Zip: _________________
Phone: ___________________________ Contact: _____________________________
INSTRUCTIONS: