Credit App Form
If Applicable
Address of Business *
Address of Business
Contact Information
Phone *
Phone
Fax *
Fax
Billing Address (If Different From Business Address)
Billing Address (If Different From Business Address)
Billing Fax Number
Billing Fax Number
Please be sure to fax copies of State Resale Certificate(s)
CREDIT APPLICATION
Bank References
Bank Address *
Bank Address
Bank Phone Number *
Bank Phone Number
Trade References
GIVE ONLY NAMES OF THOSE YOU BUY FROM ON OPEN ACCOUNT FOR AT LEAST ONE YEAR
Trade Reference Address 1 *
Trade Reference Address 1
Trade Reference Phone 1 *
Trade Reference Phone 1
Trade Reference Fax 1 *
Trade Reference Fax 1
Trade Reference Address 2 *
Trade Reference Address 2
Trade Reference Phone 2 *
Trade Reference Phone 2
Trade Reference Fax 2 *
Trade Reference Fax 2
Trade Reference Address 3 *
Trade Reference Address 3
Trade Reference Phone 3 *
Trade Reference Phone 3
Trade Reference Fax 3 *
Trade Reference Fax 3
If you have a Wells Fargo Floor Plan please include your Account Number
If You Do Not Own Your Business Location Please State Name, Address & Telephone of Landlord
I Acknowledge that I will Fax Tax Returns and State Resale Certificate(s) after clicking the Submit Button *

Please be sure to Fax over your Tax Returns and State Resale Certificate(s) after hitting the Submit Button to - 800-863-8673