Credit Application – Green America Recycling

Comments

Account

Account Name*

Invoice To:*

Address*

Street Address Address Line 2 City State ZIP Code

Customer Type*

Liquids
Solid
Both
Direct Contractor Sales

Salesman

Credit Information*

(Only if applying- for credit)

Corporation
Partnership
Proprietorship

Credit Limit Desired*

Date Business Established*

Company Officers*

Principal Name	Position	Residence Address	Residence Phone

Current Trade References*

Name	Address	City & Zip	Email Address

Current Trade References*

Name	Address	City & Zip	Email Address

Current Trade References*

Name	Address	City & Zip	Email Address

Bank References*

Name	Address	City & Zip	Phone

Bank References*

Name	Address	City & Zip	Phone

Bank References*

Name	Address	City & Zip	Phone

Person to Contact*

Current Assets

Cash on hand and in banks*

Due from customers*

Cost value of merchandise on hand*

Other current assets*

Current Liabilities

Bank loans payable within a year*

Tax obligations due*

Due to merchandise creditors*

Other debts due within a year*

Fixed Assets

Business equipment*

Land used in business*

Other fixed assets*

Indebtedness Not Due Within a Year

Chattel Mortgages due on merchandise*

Chattel Mortgages due on other assets*

Other long-term debt*

Real Estate Mortgages*

Net Worth

Monthly Sales Volume*

% of Sales made on credit*

% of Sales at retail*

% of Sales at wholesale*

% of Sales on time payment plan*

Peak season of year*

Date of last physical inventory*

Profit shown latest U.S. Income Tax return*

Signature*

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