ClothingIsland.com

Credit Application for a Business Account

Business Contact Information

Name:

Company name:

Phone:

Fax:

E-mail:

Registered company address:

City:

State: Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

ZIP Code:

Business and Credit Information

Primary business address:

City:

State: Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

ZIP Code:

How long at current address?

How Much Credit Needed:$

Time Needed To Pay: 30 Days 60 Days 90 Days

Agreement

Dear Customers:

To Meet your credit requirements we would appreciate the following information to assure that we establish the proper credit line for your company:

1.   Recent Financial Statement

2.   The name of your bank including address and account number.  

3.  Major References with which you have established an open account.

4.   By submitting this application, you authorize ClothingIsland.com to make inquiries into the banking and business/trade references that you have supplied.

5.  An Account representative will contact you within 24-48 hours