Credit Application
Please fill out the following form completely and submit to be evaluated for credit
GENERAL INFORMATION
Desired Credit Limit
Company Name
D/B/A
Bill to Address
Street Address
City/State
Zip Code
Owners(s)/President
Accts. Payable Contact
AP Phone & Fax #
AP E-mail Address
Banking Institution
Acct. Numbers
Phone & Fax #'s
Years in Business
Federal Tax ID #
Company Structure
Sole Proprietorship
Corporation State
Partnership
LLC
REFERENCES
Name Of Company
Contact
City/State
Phone
Name Of Company
Contact
City/State
Phone
Name Of Company
Contact
City/State
Phone
AUTHORIZATION
I authorize the release of the above information to Steven Enterprises Inc. for credit purposes only. In order for Steven Enterprises Inc. to grant me credit, I give permission for my credit to be checked as required for that purpose. Credit terms are net thirty (30) days from the date of invoice. Interest will be charged at 1.5% per month on items over thirty (30) days. If my account is referred for collection, I agree to pay all billing and collection costs and a reasonable attorney's fee. All the above is true and terms are accepted.
Print Officer's Name
Officer's Signature
Officer's Title
Date
Tuesday, May 13, 2008
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