I/We hereby apply for credit and certify that the following information given below is correct. Our understanding is that this information is for the use of your credit department only and will be help in the strictest of confidence. I.  COMPANY INFORMATION   Company Name: Street: Phone: City: State: Zip: Fax: Street: Phone: City: State: Zip: Fax:   Credit Needed: Tax Exempt? Exemption:   Yes   No    Type of Business:     Business Classification (check one): Incorporated      Partnership  Proprietor             Other           II.  LOCAL TRADE REFERENCES Name: Street: Phone: City: State: Zip: Fax:   II.  LOCAL TRADE REFERENCES Name: Street: Phone: City: State: Zip: Fax:   II.  LOCAL TRADE REFERENCES Name: Street: Phone: City: State: Zip: Fax:   III.  Applicant Information   Your Name:   Your Title: