Furnlite Account Credit Application

OPEN ACCOUNT CREDIT APPLICATION (min $500)

COMPANY INFORMATION
Company Name:
Billing Address:
Shipping Address:
Telephone:	Fax:	Email Address:
Corporation? (check for yes)	Partnership? (check for yes)	Proprietorship: (check for yes)
Officer 1 Name:		Officer 1 Title:
Officer 2 Name:		Officer 2 Title:
CREDIT REFERENCES
Company 1 Name:		Company 2 Name:
Company 1 Address:		Company 2 Address:
Company 1 Address:		Company 2 Address:
Company 1 City:		Company 2 City:
Company 1 State:		Company 2 State:
Company 1 Zip Code:		Company 2 Zip Code:
Company 1 Phone:		Company 2 Phone:
Company 1 Fax:		Company 2 Fax:
Company 1 Contact:		Company 2 Contact:

Company 3 Name:		Company 4 Name:
Company 3 Address:		Company 4 Address:
Company 3 Address:		Company 4 Address:
Company 3 City:		Company 4 City:
Company 3 State:		Company 4 State:
Company 3 Zip Code:		Company 4 Zip Code:
Company 3 Phone:		Company 4 Phone:
Company 3 Fax:		Company 4 Fax:
Company 3 Contact:		Company 4 Contact:
BANK INFORMATION
Bank Name 1:		Bank Name 2:
Bank 1 Account:		Bank 2 Account: