Needlecraft, Inc.
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Needlecraft, Inc. Credit Application
Business Name:
Other Business Name:
Business Address:
City: State: Zip:
Contact:
Telephone #:
Fax #:
Federal ID#:
e-mail:
Type of Business:
Date Started: Annual Sales: # Employees:

CHECK TYPE OF ORGANIZATION
SOLE PROPRIETORSHIP (give legal name of Proprietor, residence address, residence telephone #, Social Security #)
PARTNERSHIP (give the full names, addresses, phone #, and Social Security # of all partners)
CORPORATION (give names, addresses and telephone #, and Social Security # of officers)
1
Name & Title Residential Address
City State Zip
Telephone Social Security #
2
Name & Title Residential Address
City State Zip
Telephone Social Security #
3
Name & Title Residential Address
City State Zip
Telephone Social Security #

BANK REFERENCE
Name:
Contact:
Phone:
Street:
City: State: Zip:

TRADE CREDIT REFERENCES
1
Name
City State Zip
Phone # Fax #
2
Name
City State Zip
Phone # Fax #
3
Name
City State Zip
Phone # Fax #

I/We hereby authorize you or any credit reporting agency employed by you to investigate the references herein listed or to investigate my/our personal credit and financial records including my/our banking records. I/We hereby certify that I/we have read this form thoroughly and accept its conditions. I/ We further state that all information supplied by me/us is true in fact and intent.
Please select this check box if you have read and agree to the above terms