NET TERMS CREDIT APPLICATION

Step 1

Take 5-10 minutes to breeze through the application form below. We can't wait to start working with you!

Corporate Name

DBA

Business Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Owner(s)

Years in Business

Phone

(###)

###

####

Fax

(###)

###

####

A/P Contact

Federal Tax ID

Choose one

Corp

Partnership

Proprietorship

Principal

Other

Bank Reference Name

Bank Reference Street

Bank Reference City / State / Zip

Bank Reference Acct#

Bank Reference Acct Officer

Bank Reference Phone

(###)

###

####

Bank Reference Fax

(###)

###

####

Trade Reference 1 Name

Trade Reference 1 Street

Trade Reference 1 City / State / Zip

Trade Reference 1 Phone

(###)

###

####

Trade Reference 1 Fax

(###)

###

####

Trade Reference 2 Name

Trade Reference 2 Street

Trade Reference 2 City / State / Zip

Trade Reference 2 Phone

(###)

###

####

Trade Reference 2 Fax

(###)

###

####

I hereby authorize the above listed bank and trade sources to release pertinent information to Hilldun, The CIT Group / Commercial Services Inc., Wells Fargo Capital Finance and Clara S Inc.

Signed

Title

Date

YYYY

STEP 2

Wait 24-48 hours for approval (Processed by Hilldun Corporation). Easy! For now contact your account executive you’ve been working with to access our wholesale buyer’s access and more. Thank you so much and we look forward to working with you!