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 Thursday, July 29, 2010