MARFRED INDUSTRIES
Corporate Office
12708 Branford Street ¨ Sun Valley, CA 91353-2048
(818) 896-0550 h FAX (818) 890-9532
STANDARD
CREDIT APPLICATION: - Please
fill out form completely
Date:__________________________________
Salesperson: ________________________________________
CUSTOMER NAME:
______________________________________________________("Customer")
Billing Address: _________________________________________________________________________________
Delivery Address: ___________________________________________________________________________________
City/State/Zip Code: ___________________________________________________________________________________
Contact Person _________________________________________________Title______________________________
Please Check one: Individual________ Partnership________
Corporation________ Govt.________
In business since:______________________ State/Date
Incorporated:____________________________/ ______________
Type of business or Service: __________________________________________________________________________________
Phone # : _______________________________________________________FAX
#:____________________________________
PRINCIPALS:
Name:__________________________________________________________
Title:_____________________________________
Name:__________________________________________________________
Title:_____________________________________
Name:__________________________________________________________
Title:_____________________________________
CREDIT REFERENCES:
________________________________________________________________________________________________
Name Address Phone Acct. No
________________________________________________________________________________________________
Name Address Phone Acct. No
________________________________________________________________________________________________
Name Address Phone Acct. No
BANK:
________________________________________________________________________________________________
Name Address Phone Acct. No
________________________________________________________________________________________________
Name Address Phone Acct. No
AUTHORIZATION:
I hereby grant permission to above named banking institution
to release information to Marfred Industries.
Credit line desired $________________ Would financial
information be available upon request? ____________
(Please read reverse side
for Marfred Industries’ Terms and conditions.)
By virtue of my signature I hereby acknowledge
the Terms and Conditions as stated on the reverse side of this document.
By: ________________________________________ Title:_________________________________________
Date: ________________________________________
(Customer’s Authorized Representative)
PLEASE BE ASSURED: All
information provided would be held in the strictest confidence. THANK
YOU!
