To be considered for credit, please print and complete the form below. Click here for a pdf version.
After completion please use the mailing information below to submit your credit application:
CONFIDENTIAL CREDIT APPLICATION
3231 East 15th St., Tulsa, OK, 74104
918-744-0837 Fax: 918-744-1075
E-mail: bewleysweeper@sbcglobal.net Attn: Becky
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_________________________________________________________________
Name of Business___________________________________ Date___________
Address________________________________________ Phone____________
City_________________ State_______ Zip Code________ Fax______________
Nature of Business: ________________________________Date Est.__________
Tax No./ Social Security No.___________________________________________
_________________________________________________________________
TYPE OF BUSINESS OWNERS/OFFICERS
_________________________________________________________________
_____Corporation President________________________________
_____Partnership Vice President____________________________
_____Individually owned Secretary________________________________
Treasurer________________________________
* Estimated Monthly Credit Requirement*__________________
_________________________________________________________________
To support this application for credit, please attach a current financial statement.
_________________________________________________________________
Name of Bank___________________________________ Phone____________
Person To Contact__________________________________________________
Type of Account ________Checking ________Savings ________Loan
Account Number _______________ ______________ ____________
_________________________________________________________________
CREDIT REFERENCES
_________________________________________________________________
Name_______________________ Contact____________ Phone____________
Address_____________________ City____________ State______ Zip_________
Name_______________________ Contact____________ Phone____________
Address_____________________ City____________ State______ Zip_________
Name_______________________ Contact____________ Phone____________
Address_____________________ City____________ State______ Zip_________
_________________________________________________________________
Conditions of Sale and Terms of Payment
_________________________________________________________________
In consideration for any extension of credit, purchaser agrees to the terms hereof and to the conditions of sale set forth on each invoice. Purchaser also agrees to pay a service charge of one and one-half percent per month (or the maximum allowable contract rate under state statutes), computed on the unpaid balance until the account is paid in full. The purchaser also agrees to pay reasonable attorney fees and other costs incurred for collection.
AUTHORIZED SIGNATURE_________________________TITLE____________
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