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Please fill in the information requested below. Please note: If your company is tax exempt, a Tax Exempt Certificate must accompany this credit application. In the event your company is renting a forklift, a Certificate of Insurance is required showing all applicable coverage's.

Company Applying for Credit
Name:
Address:
Address cont.
P.O. Box
City
State/ZIP

Type of Business:
Corporation Partnership Individual Other

Telephone #:
Fax #:
E-mail Address:
Federal Tax ID:
DUNS #:

Principal's Name:

Bank References
Name of Bank:
Address:
City:
State/ZIP
Telephone
Fax
Contact
Account Number

Trade References
1. Company
Address
Address (cont.)
Telephone
Fax

2. Company
Address
Address (cont.)
Telephone
Fax

3. Company
Address
Address (cont.)
Telephone
Fax

4. Company
Address
Address (cont.)
Telephone
Fax

Date: Signed: Title:

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Credit Application