395 Hughes Drive, Traverse City, Michigan 49696 Tel: 231-947-2120 - Fax: 231-922-0609

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231.947.2120 ph
231.922.0609 fax
800.493.2951 toll free

395 Hughes Drive
Traverse City, MI 49696

CREDIT
APPLICATION


This agreement and Guaranty hereunder covers purchases made from any division and subsidiary of seller.

Contact Information

Name

Office Phone Number

Fax Number

Cell Number

Pager Number

Current Address

City

State

Zip

If current address is less than one year, please list previous address.

Previous Address

City

State

Zip

E-mail Address

Type of Business

Please select type of business (or, individual application)

Corporation   Sole Proprietorship   Co-Partnership   Individual Application

If Individual Application, please list your Social Security Number

Builder's License Information
Please mail or fax a copy of your contractor pocket card

Fax: 231.922.0609   Mail:395 Hughes Drive Traverse City, MI 49686

Registered Name

License Number

Business Information

Current Name

Years Under Current Name

Previous Name

Years Under Previous Name

PO's Required

Tax ID Number

Tax Exempt?

Yes   No
If tax exempt, please mail or fax a copy of your certificate

Fax: 231.922.0609   Mail:395 Hughes Drive Traverse City, MI 49686

Amount of credit applying for

$

Drivers License Number

Are there any outstanding judgments against you?

Bank

Account Number

Type of Account

Bank Address

City

State

Zip

Bank Phone Number

Principal Owner, Stockholders or General Partners

Name

Social Security Number

Address

City

State

Zip


Name

Social Security Number

Address

City

State

Zip


Name

Social Security Number

Address

City

State

Zip


Principal Sources of Credit

Name

Phone

Address

City

State

Zip


Name

Phone

Address

City

State

Zip


Name

Phone

Address

City

State

Zip








Call 800-493-2951 for more information today!