In-House Credit Application - Texoma Utility

In-House Credit Application

Company Name

DBA

Physical Address

Phone

Fax

Mailing Address

City

State

Zipcode

Field type not supported: MULTI_CHOICE.

FEIN/SSN

Years In Buisness

Type of Buisness

AMOUNT OF CREDIT REQUESTED

Field type not supported: MULTI_CHOICE.

PRINCIPAL(S) OR GUARANTOR(S)

Name

Title/ % Ownership

Home Address / Phone

SS#

Name

Title/ % Ownership

Home Address / Phone

SS#

BANK REFERENCES (NO LESS THAN TWO YEAR HISTORY)

Name

Phone

Account #/ Type

Contact Name

Name

Phone

Account #/ Type

Contact Name

TRADE REFERENCES

Company Name

Address

Phone

Fax

Contact

Account #

Company Name

Address

Phone

Fax

Contact

Account #

CREDIT RELEASE

Sign Here

Date