APPLICATION FOR CREDIT
COMPANY NAME:
____________________________________________________________________
BUSINESS
ADDRESS:
____________________________________________________________
CITY, STATE,
ZIP:
________________________________________________________________
PHONE:
_________________________ FAX:
__________________________________
HEREBY applies for credit in
accordance with the terms and conditions of:
Bennett Packaging of Kansas City, Inc.
220 NW Space Center Circle CREDIT MANAGER: _______________________
Lee’s Summit, MO 64064 OUR NORMAL
CREDIT TERMS: _____________
The following information must be
provided. It will be held in the
strictest confidence.
TYPE OF BUSINESS: _______________________________________________________________________
D-U-N-S NUMBER:
___________________________
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YEAR BUSNESS STARTED: |
YEARS AT
PRESENT LOCATION: |
TYPE OF ORGANIZATION: ¨ PRIVATE CORPORATION ¨ PARTNERSHIP
¨ PUBLIC
CORPORATION ¨ INDIVIDUAL
OFFICERS:
NAME: POSITION: HOME ADDRESS: PHONE:
_____________________ _____________________ ___________________________ _______________
_____________________ _____________________ ___________________________ _______________
_____________________ _____________________ ___________________________ _______________
_____________________ _____________________ ___________________________ _______________
BANKING
REFERENCES (INCLUDE ACCT# & CONTACT)
NAME OF BANK TELEPHONE
& FAX# CONTACT
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TRADE REFERENCES: (INCLUDE ADDRESS,
PHONE & FAX #’S)
NAME OF COMPANY ADDRESS PHONE & FAX#
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We
certify that all the information on this form is correct. We fully understand your credit terms and
agree to the proper payment in consideration of extended credit.
When
sending this back, please include a tax exemption form completely filled out
for proper billing.