Credit Application NAME OF COMPANY SHIPPING ADDRESS CITY, STATE & ZIP CODE PHONE NUMBER FAX NUMBER BILLING ADDRESS (IF DIFFERENT) CITY, STATE & ZIP CODE PHONE NUMBER FAX NUMBER WE OPERATE AS A: CORPORATE   PARTNERSHIP/JOINT VENTURE   OTHER PARENT COMPANY OTHER AFFILIATIONS NAMES OF PRINCIPALS & TITLES YEARS ESTABLISHED DUNN & BRADSTREET NUMBER INDIVIDUAL IN CHARGE OF ACCOUNTS PAYABLE NAME OF BANK BANK ADDRESS CITY, STATE & ZIP CODE ACCOUNT NO. PREVENT DELAY IN PROCESSING ORDER. KINDLY FURNISH COMPLETE INFORMATION ON THE BLANKS BELOW Principle Suppliers are: (purchases within last 90 to 120 days) 1. Name Address City, State, Zip Phone# Fax# 2. Name Address City, State, Zip Phone# Fax# 3. Name Address City, State, Zip Phone# Fax# 4. Name Address City, State, Zip Phone# Fax# In the event credit is extended, the applicant agrees to pay all costs and expenses, including actual and reasonable attorney fees incurred by the creditor in collection of any outstanding accounts. The applicant hereby authorizes DEL-REN ASSOCIATES, INC. to take appropriate measures in verifying the credit of and releases DEL-REN ASSOCIATES, INC. from any obligation and restrictions imposed by law while researching this information.     Applicant Signature [ our team | product lines | how to do business with us ] [ order stock fans online | what's new | directions | home ] Job Opportunities