Credit Applied For Plant Location Select City Fort Smith McAlester Muskogee Poteau Stigler Tahlequah Tulsa Wilburton TIN/SSN
Legal Business Name
Street Address Phone No.
Mailing Address Fax No.
City State Zip Code Cell No.
E-Mail Address Website
Type of Business Corporate Partnership Sole Proprietorship
Year Established Nature of Business
Names of Officers or Owners of Firm, Title, and Social Security Numbers:
Bank Affiliation Bank Officer
Address Phone No. Fax No.
Checking Account No. Savings Account No.
Are Purchase Orders Required?YesNo Are Purchases Taxable?YesNo
Names of Authorized Buyers on this account:
Have you filed bankruptcy in the past seven years? YesNo
If yes, what year?
Business References: (business name, address, phone, and fax)
1. 2. 3.
I, the undersigned, am an officer of this company and authorized to sign this application for
credit.I understand that if credit is approved my signature enters the company into a binding
agreement to the terms of credit set forth and guarantees payment of this account. I acknowldge
that purchases made on this account are due the first (1st) day of the month following purchase
and past due after the tenth (10th) of the month following purchase; finance fees will be charged
after due date at a rate of .833% per month or 10% per annum. I understand that failure to make
payment within the terms set forth will result in legal action and that all costs and fees
resulting through effort to collect monies will be the responsibility of my company. I , the
undersigned, also give my permission for Twin Cities to obtain the credit reports necessary to
establish credit worthiness.