Credit Application

Thank you for your recent inquiry with INDCO, Inc. Please fill out the following required information so that we may set up/update your account with our company. It is important that the information be accurate and complete so as not to delay the processing of your credit references to establish terms and a credit limit with INDCO. If you have any questions, please feel free to contact our Customer Service Department at 1-800-942-4383. Thank you in advance for your cooperation and prompt response.

Required Information

Company Name (Full Legal Name):

Doing Business As (DBA):

Billing Address:

Shipping Address:

Phone Number:

Fax Number:

Email Address:

Nature of Business:

Accounts Payable Manager:

Phone Number/Email Address:

Purchasing Manager:

Phone Number/Email Address:

Owner/President:

Phone/Email Address:

Year Established

Federal Tax ID Number:

Tax Exemption Number:

Has the company filed bankruptcy in the past ten years?

If yes, please provide date filed.

APPLICANT'S SIGNATURE ATTESTS FINANCIAL RESPONSIBILITY, ABILITY AND WILLINGNESS TO PAY OUR INVOICES IN ACCORDANCE WITH THE FOLLOWING TERMS: NET 30 DAYS. SIGNATURE ALSO GUARANTEES ALL INFORMATION IS ACCURATE AND FACTUAL, AND ALLOWS INDCO PERMISSION TO CONTACT ANY REFERENCE FOR VERIFICATION OF CREDIT WORTHINESS. IN THE EVENT A SUIT OR COLLECTION AGENCY IS NECESSARY TO COLLECT ANY AMOUNT, APPLICANT AGREES TO PAY INDCO'S REASONABLE ATTORNEY AND/OR COLLECTION FEES.

Authorized Bank Account Holder's Signature:

Print Name:

Title:

Date:

References

Please supply 1 bank and 3 trade references.

Choose one

Upload Reference Document
Enter Bank and Trade References Here

Upload Bank and Trade Reference Document

Bank Reference Institution Name:

Bank Reference Account Number:

Bank Reference Phone/Email Address

Trade Reference 1 Company Name:

Trade Reference 1 Contact Name:

Trade Reference 1 Contact Phone/Email Address:

Trade Reference 2 Company Name:

Trade Reference 2 Contact Name:

Trade Reference 2 Contact Phone/Email Address:

Trade Reference 3 Company Name:

Trade Reference 3 Contact Name:

Trade Reference 3 Contact Phone/Email Address:

Credit Application (pdf)

186 KB

Credit Application

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