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Business Credit Application

Name/Address

Last:

First:

 

Middle Initial:

 

Title

 

 

 

 

 

 

Name of Business:

 

 

 

 

Tax I.D. Number

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

City:

State:

ZIP:

 

Phone:

 

 

 

 

 

 

Company Information

 

Type of Business:

 

 

 

In Business Since:

 

 

 

 

 

 

 

 

 

 

 

Legal Form Under Which Business Operates:

 

 

 

 

 

 

 

Corporation

Partnership

Proprietorship

 

 

If Division/Subsidiary, Name of Parent Company:

In Business Since:

 

 

 

 

 

 

 

 

 

Name of Company Principal Responsible for Business Transactions:

Title:

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

City:

 

State:

ZIP:

Phone:

 

 

 

 

 

 

 

 

 

Name of Company Principal Responsible for Business Transactions:

Title:

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

City:

 

State:

ZIP:

Phone:

 

 

 

 

 

 

 

 

 

 

Bank References

 

 

 

 

 

 

 

 

Institution Name:

 

 

Institution Name:

 

Institution Name:

 

 

 

 

 

 

 

 

 

Checking Account #:

 

 

Savings Account #:

 

Home Equity Loan:

ILoan Balance:

 

Address:

 

 

Address:

 

Address:

 

Phone:

Phone:

Phone:

Trade References

Company Name:

Company Name:

Company Name:

 

 

 

Contact Name:

Contact Name:

Contact Name:

 

 

 

Address:

Address:

Address:

 

 

 

Phone:

Phone:

Phone:

 

 

 

Account Opened Since:

Account Opened Since:

Account Opened Since:

 

 

 

Credit Limit:

Credit Limit:

Credit Limit:

 

 

 

Current Balance:

Current Balance:

Current Balance:

 

 

 

I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein.

_________________________________________________________ ______________________________________

Signature

Date

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  • Lease Application: When a business wants to lease equipment or property, this document is required. It evaluates the business's financial stability and ability to meet lease obligations, paralleling the credit assessment in a Business Credit Application.

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