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Credit Application
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If you wish to fax the Credit Application to us rather of using the online form provided for you below, Click Here to download the PDF version.

 

CREDIT APPLICATION - Please be sure to fill in all required fields marked with a * before submitting.
 
* Legal Name:
* DBA:
* Billing Address:
* City:
* State:
* Postal Code:
* A/P Contact:
* Purchasing Contact:
* Phone Number:
Fax Number:
* Yrs/Business:
* Tax Exempt: Exemption #:
* Corporate Entity:
* Federal Employer Identification #:
* Duns #:
* Email Address:

BANK INFORMATION
 
* Financial Institution / Bank Name:
* Account Number:
* Account Type:
* Contact Name / Title:
* City:
* State:
* Phone Number:
Fax Number:

TRADE REFERENCES
FIRST REFERENCE
Company Name:
Contact Name:
City:
State:
Phone Number:
Fax Number:

SECOND REFERENCE
Company Name:
Contact Name:
City:
State:
Phone Number:
Fax Number:

THIRD REFERENCE
Company Name:
Contact Name:
City:
State:
Phone Number:
Fax Number:

Digital Signature - By Typing your name and title below, you hereby authorize Telling Industries to process the credit application above.
* Applicant Name:
* Applicant Title:
 

 

 

 

 

 

 

 

 

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