Southwest Processors Inc.

Credit Application

Date
MM slash DD slash YYYY
Company Name

DBA (if any)
Physical Address
Street Address City State ZIP Code
Mailing Address (if different than above)
Street Address City State ZIP Code
How long have you been in business?
Type of Buisiness
- Individual
- Partnership
- Corporation
Contact Name
First Last
Contact Phone
Contact Fax
Contact Email
Accounting Information
Accounts Payable*
Accounts Payable Phone*
Accounts Payable Email*
Controller
Controller Phone
Bank
Bank Phone
Bank Address
Street Address City State ZIP Code
Reference Information
List three trade supplier references the company had done business with in the last six months:
1. Company Name
1. Company Address*
Street Address City State ZIP Code
1. Company Phone*
1. Company Fax*
1. Company Email*
2. Company Name*
2. Company Address*
Street Address City State ZIP Code
2. Company Phone*
2. Company Fax*
2. Company Email*
3. Company Name*
3. Company Address*
Street Address City State ZIP Code
3. Company Phone*
3. Company Fax*
3. Company Email*
Pricipal
In consideration of opening a line of credit with Southwest Processors, Inc., it is agrees that the undersigned will pay all sums when due and according to the terms of the invoice. I authorize you to contact references and to obtain information from outside sources that may be needed to obtain credit.
Principal
Title
Date
MM slash DD slash YYYY

800.900.3366 / 323.269.9876