Here’s a basic business credit application form that you can use:
[Company Name]
[Company Address]
[City, State ZIP Code]
[Company Phone Number]
[Company Email]
Business Credit Application Form
[Business Name]
[Business Address]
[City, State ZIP Code]
[Business Phone Number]
[Business Email]
[Date]
Business Information:
- Business Structure: [Sole Proprietorship/Partnership/Corporation/Limited Liability Company]
- Federal Tax ID Number: [Enter Tax ID Number]
- Date Established: [Enter Date Established]
- Legal Name: [Enter Legal Name]
- Business License Number: [Enter License Number]
- State of Incorporation: [Enter State of Incorporation]
- Type of Business: [Enter Type of Business]
Bank References:
- Bank Name: [Enter Bank Name]
- Account Number: [Enter Account Number]
- Contact Person: [Enter Contact Person]
- Phone Number: [Enter Phone Number]
- Fax Number: [Enter Fax Number]
Trade References:
- Trade Reference 1:
- Name: [Enter Name]
- Address: [Enter Address]
- Phone Number: [Enter Phone Number]
- Fax Number: [Enter Fax Number]
- Trade Reference 2:
- Name: [Enter Name]
- Address: [Enter Address]
- Phone Number: [Enter Phone Number]
- Fax Number: [Enter Fax Number]
- Trade Reference 3:
- Name: [Enter Name]
- Address: [Enter Address]
- Phone Number: [Enter Phone Number]
- Fax Number: [Enter Fax Number]
Credit Requested:
- Credit Limit Requested: [Enter Credit Limit Requested]
- Payment Terms Requested: [Enter Payment Terms Requested]
Agreement:
I certify that the above information is correct and accurate. By signing below, I authorize [Company Name] to check my credit and financial references and to use this information in determining whether to extend credit to my business.
[Business Owner Signature]
[Date]
Accepted By:
[Company Representative Name]
[Company Representative Signature]
[Date]