Credit Application for Net 30 terms

Please complete the form below and return it to you account manager.

TCI Credit App 2019

Credit Application
Business Name: _____________________________________________________________________
Billing Address: _____________________________________________________________________
City, State, Zip: ____________________________________________________________________
Telephone: _____________________________ Fax: ____________________________________
Type of Business: [ ] Corporation [ ] Partnership [ ] Proprietorship
Years in Business: _______________________ EIN#: ___________________________________
Contact in Accounts Payable: _________________________________________________________
A/P E-mail Address: _________________________________________________________________
Bank: __________________________________ Account Number: _________________________
Address: ___________________________________________________________________________
Telephone: _____________________________ Fax: _____________________________________
Credit References – Name, Address, Telephone Number, Contact Name and E-mail
1. _________________________________________________________________________________
2. _________________________________________________________________________________
3. _________________________________________________________________________________
Anticipated Monthly Purchases: _________________________________________________