Print Out This Application, Complete and Mail To:
| Aztec Rental Center 2069 Apperson Drive Salem Virginia 24153 |
Phone: (540) 989-1231 or FAX: (540) 989-5140
E-mail:
credit@aztecrental.com
Credit Application
Name of Firm or
Corporation_______________________________________________________________
Street
Address__________________________________________________________________________
Mailing
Address_________________________________________________________________________
City___________________________________________State__________________ZIP_______________
Phone No.________________________________ Purchase Order
Required? ________ Yes________ No
FAX No._____________________________ Tax Exempt? ____ Yes ____
No No. ___________________
Our Legal entity is: ___________Corporation
___________Partnership ___________Proprietorship
Principal Owner(s) or
President________________________________________________________________
__________________________________________________________________________________________
Manager or
Foreman_________________________________________________________________________
Authorized Agents:
___________________________________________________________________________
___________________________________________________________________________
Credit References
|
Name of Company |
Address |
Telephone No. |
1.
___________________________________________________________________________________________________
2.
___________________________________________________________________________________________________
3.
___________________________________________________________________________________________________
4.
___________________________________________________________________________________________________
Banks
|
Name of Bank |
Address |
Telephone No. |
1.
___________________________________________________________________________________________________
2.
___________________________________________________________________________________________________
3.
___________________________________________________________________________________________________
4.
___________________________________________________________________________________________________
Authorization to Release Information
I hereby authorize our bank(s) to release any information
necessary to assist in establishing a line of credit.
Firm Name_____________________________________________________________________________
Address_______________________________________________________________________________
City____________________________________State_______________ZIP________________________
Authorized by:__________________________________________________________________________
Title_______________________________________________Date________________________________