D&D Wholesale Distributors, Inc.
Credit Application.
777 Baldwin Park Blvd.
City of Industry, CA. 91746

  

Business Name:
For how many years?:
Address:
Type of Business:
City:
Date established:
State:
 
Zip Code:
 
Does the County, State or City require a licence?: Yes: No: If yes please provide licence number:
   
(Ownership)
Sole: Partnership: Corporation:  
(Principal)
Name:
Title:
SS#:
   
Home Address:    
       
Name:
Title:
SS#:
 
Home Address:    
       

 



 

 

 

 

 

 

 

 

 


(Trade References)

Name: Address:
Name: Address:
Name:
Address:
Name: Address:

(Bank References)

Checking: Savings:

#1 Name: Address:
Account #: Contact:
#2 Name: Address:
Account #: Contact:
#3 Name: Address:
Account #: Contact:

Has the firm or any of it's Principals ever been bankrupt?
Yes: No:

If yes please give a detailed description why.


What time of month do you pay your invoices?
Day of each month.

Person to contact about account:
Title:

Terms Please read carefully before aggreeing.




______________________________________________________________________________________

Personal guarantee:



Name: Title:
Name: Title:
By filling in the above boxes the said guarantor or guarantors are bound by this agreement.


By filling in the two boxes below you are agreeing to
the terms listed in the afformentioned statement.
this document will be kept on file as proof of signature.
Name: Date: