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DEALER LOGIN
StoneTrends Credit Application
First name
Last name
Title
Phone
Email
Company Information
Business / Organization
Address Line 1
Address Line 2
City
State
Zip Code
Tax ID Number
In Business Since
Legal Form Under Which Business Operates
Name Of Parent Company/In Business Since
Credit Line Requested
Payment Terms Requested
Name of Company Principal Responsible for Business Transactions
First name
Last name
Company Principal Title
Address
Phone
Bank References
Institution Name
Account Number
Address
Phone
2nd Institution (if applicable)
Institution Name
Account Number
Address
Phone
3rd Institution (if applicable)
Institution Name
Account Number
Address
Phone
Trade References
Company Name
Primary Contact Name(s)
Phone
Email
Address
2nd Reference
Company Name
Primary Contact Name(s)
Phone
Email
Address
3rd Reference
Company Name
Primary Contact Name(s)
Phone
Email
Address
Your Signature
Clear
I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and conditions of the credit to be extended. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to the company for which credit is being applied for in order to verify the information contained herein.
Submit
Thank you for your submission!
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