CREDIT APPLICATION AND CREDIT AGREEMENTCredit Application and Credit Agreement • September 22nd, 2021
Contract Type FiledSeptember 22nd, 2021CUSTOMER INFORMATION (“Applicant”) FULL LEGAL NAME (Entity): Entity Type: Corporation Partnership Sole Proprietorship LLC State of incorporation or origin: Street Address: City/State/Zip: PO Box: Phone: Fax: Email: Federal Tax ID or SSN: Number of Years in Business: Contractor’s Lic. No.: Franchise Hauler No.: Credit Limit Requested: $ _ Health Department No.: