Attention Betty Goertzen - Call:(559)222-7366 or Fax:(559)229-8650
bof - CREDIT APPLICATION
Persons/Persons Authorized to Charge:
 
Company Name:
Mailing Address:
Phone Number (include Area Code):
How Long In Business:
Contact Person:
Position:
Incorporated(Y/N):Partnership(Y/N):Sole Prop(Y/N):State:
List all Owners, Partners or Officers With Title and Home Address:
Name Address Social Security#
     
     
     
     
Please Name three Trade References With Addresses and Phone Numbers:
Name Address Phone Number
     
     
     
     
Banking:
Name of Account Holder:
Bank Name:
Mailing Address:
Account Number:
Phone Number (include Area Code):
Type of Account:

Terms: Net 15 Days Upon Receipt of Invoice
I, _______________________, personally guarantee payment of all obligations and do hereby agree to bind myself to pay bof on demand any sums which may become due by the customer. Date:_____________