Credit Terms ApplicationCredit Terms Application Business InformationThis field is hidden when viewing the formAgent NameThis field is hidden when viewing the formAgent EmailThis field is hidden when viewing the formSigner nameThis field is hidden when viewing the formSigner EmailLegal Name of Business(Required)Address(Required)City(Required)State(Required)Zip Code(Required)Tel(Required)FaxFederal Tax ID#(Required)Type of Ownership(Required) Corporation Partnership Proprietorship Corporation DetailPresident / General Manager / CEO(Required)Phone(Required)Email(Required) Chief Financial OfficerPhoneEmail Vice-PresidentPhoneEmail (if Applicable) SUBSIDIARY DIVISION BRANCH OF Partnership OR Proprietorship DetailNameSS#EmailPhone Bank ReferenceName(Required)Branch(Required)Account#(Required)Bank Officer(Required)Telephone(Required)City/State(Required) Credit ReferencesNameNameCity/StateCity/StateTelFaxTelFax