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Online Credit Application

Property Name: Phone: Legal Name: Phone:
Please Select One: Sole Proprietorshop   Partnership   Corporation   Other
Delivery Address: City: State: Zip:
Billing Address: City: State: Zip:
Management Company Name: Ownership/Corporate Information:

Trade References

Name: Account #: Phone: Fax:
Name: Account #: Phone: Fax:
Name: Account #: Phone: Fax:

Account Payable Information

Community Supervisor: Email:
DOB: Phone: Fax:
Community Manager: Email:
DOB: Phone: Fax:
A/P Management Contact: Email:
Phone: Fax:
Date You Took Over Management: Date Property Purchased: (If applicable) Number of Units:
Purchase Order # Required: Yes   No Are Your Sales Exempt (If Yes Certification Must Be Emailed): Yes   No Approx. Monthly Purchases:
Please enter in the following words:

* I agree the above information to be true and correct, that it is submitted for the purpose of obtaining credit and agrees to the Terms and Conditions of Sales of Seller on reverse side and any changes to those terms, which may occur in the future; and further acknowledges and agrees that applicant is authorized to bind itself and its principal in accordance with the terms herewith; all of which are herein incorporated by reference. The undersigned further authorizes Seller to request and receive credit reports from credit bureaus and other credit service organizations regarding the undersigned's personal credit for the purpose of investigating the Purchaser's business and its eligibility for commercial credit. The undersigned consents to an investigation into the creditworthiness of the Purchaser.

* Your Name:
Your Title: