Credit Application

To serve you more quickly, please provide as much information as possible.

Are you applying for an increase in your current credit limit with Enterprise Computer, LLC.?  
Credit Line / Increase Amount Requested (if applicable):

Use the comment box below for any specific requests.
(Fields in red and marked with asterisks are required fields.)

Customer Number:
Sales Rep:
* Company Name:
Email Address:
* Address:
Address 2:
City:
* State/Province:
* Country:
* Zip/Postal Code:
* Phone Number:
Fax Number:
* Owners or Principals:
* Type of Business:
* Date Incorporated:
* Sales Tax Exempt #:
Federal ID #:
SS#:

Trade References
Company Name #1:
  Address:
  Account #:
  Phone #:
Company Name #2:
  Address:
  Account #:
  Phone #:
Company Name #3:
  Address:
  Account #:
  Phone #:

Failure to include trade references may delay credit approval.
 
Bank Reference
* Bank Name:
* Type of Account:
* Address:
* Account #:
* Phone #:
 
Comment/Question/Details:
 

Enterprise Computer, LLC. reserves the right to repossess all goods equaling the delinquent amount, if the undersigned remains in default. The undersigned personally guarantees payment of all goods sold. In case of default, should Enterprise Computer, LLC. resort to litigation, the undersigned will be responsible for court costs and reasonable attorney fees.

AUTHORIZATION:

The undersigned authorizes release of all banking and credit information, both business and/or personal requested by Enterprise Computer, LLC.
 
* Name:
* Title:
* Date: