Credit Application

Referenced documents: Business Credit Packet

Name & Address

First Name

Last Name

Title

Name of Business

Tax ID Number

Business Address

City

State

Zip Code

Phone Number

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 Code

Phone Number

Name of Company Principal Responsible for Business Transactions

Title

Address

City

State

Zip Code

Phone Number

Bank References

Institution Name - Checking Account

Bank Address

Bank Phone Number

Trade References

Reference #1 -Company Name

Contact Name

Address

Phone Number

Account Opened Since

Credit Limit

Current Balance

Reference #2 -Company Name

Contact Name

Address

Phone Number

Account Opened Since

Credit Limit

Current Balance

Reference #3 -Company Name

Contact Name

Address

Phone Number

Account Opened Since

Credit Limit

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

Clear

Date

Credit Card Authorization Form

MasterCard

VISA

Discover

AMEX

Other:

Cardholder Name

Expiration Date (MM/YYYY):

ZIP Code (from credit card billing address)

Your Name

I authorize P & G Crane to charge my credit card above for agreed upon purchases. I understand that my information will be saved to file for future transactions on my account.

Signature

Clear

Date

AGREEMENT

Signature below is an acceptance of terms and conditions set forth in this agreement and certification that information on this form is correct.

Title

Name

Signature

Clear

Date

Credit Application

Name & Address

Company Information

Legal Form Under Which Business Operates:

Bank References

Trade References

Credit Card Authorization Form

AGREEMENT

Choosing The Right Crane

CONTACT

INFORMATION

DOCUMENTS