WMJ MARINE - CREDIT APPLICATION
Business Background | |
Name: | How many years in business? |
Street Address: | Federal Tax ID#: |
City, State, Zip code: | Ownership: __ Sole Owner __ Partnership __ Corporation |
Country: | Principal Name:
|
Phone: | Buy's Name:
|
Fax: | Accounts Payables:
|
E-mail: |
Trade References
#1 Reference
Company Name Address:
Phone: Fax: Account #: |
#2 Reference
Company Name Address:
Phone: Fax: Account #: |
#3 Reference
Company Name Address:
Phone: Fax: Account #: |
Bank Reference
Bank Name Address:
_ Checking __ Saving Phone: Fax: Account #: |
Has the firm or any of its Principals
ever filed bankruptcy?
__ Yes __ No
I hereby authorize my bank _______________ to release any information needed on account # ______________ to WMJ Marine.
___________________________________ Signature ____________________ Date
___________________________________ Print Name
___________________________________ Signature ____________________ Date
___________________________________ Print Name
PLEASE COMPLETE THIS FORM AND FAX THIS APPLICATION TO 501 631 4759
ATTN: CREDIT APPLICATION
WMJ MARINE