Credit Application

FACO, LLC
www.facollc.com		 CREDIT APPLICATION 5124 East 65th St.
Indianapolis, IN 46220
Ph: 317-257-2211
Fax: 317.257-8150

We sincerely appreciate your business. However, before establishing an open account, our Accounting Department requires the following information. Thank you for your cooperation.

Company Information:
Company Name
Billing Address
Shipping Address
Phone
Fax
Web
E-mail
Business Type
Tax Exempt #
Year Established


Key Personnel (please include A/P contact):

 
  Name Title
  Name Title
  Name Title
  Name Title

Credit References (please provide three trade references):

Name
Address
City/State/Zip
Phone
Fax
 
Name
Address
City/State/Zip
Phone
Fax
 
Name
Address
City/State/Zip
Phone
Fax
 


Release Authorization:

I hereby authorize our bank(s) to release and information necessary to assist in establishing a line of credit.
Name
Click check box to authorize. 		Title
 Date

       

 

 




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