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Credit Application

Credit Application

Applicants Name (Exact Legal Business Name)

Applicants "Doing Business As" (DBA Name)

Bill to Address/City/State/Zip

Ship to Address/City/State/Zip

Phone Number

Fax Number

Resale Number

E-mail Address

Annual Sales

How Long in Business?

Federal Tax ID

Legal Status

Invoice Method

Invoice E-mail or Fax Number

Trade References

Name	Address	Phone	Fax

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