Application For Credit

SWAN LABEL & TAG
P. O. Box 308, 929 Second Avenue
Coraopolis, PA 15108
Credit Terms 1% 10 NET 30 DAYS		 JILL CLENDENNING, Credit Manager
(412) 264-9000 PH (412) 264-7259 FAX
Web Address: www.swanlabel.com
1st Order C.O.D. Until Credit is Established

____________________________________
Name

____________________________________
Address

____________________________________
City                                                   State     Zip Code
_____________________________
Telephone

_____________________________
Number of Years at This Address

_____________________________
Phone To Contact

THE FOLLOWING MUST BE COMPLETED IN FULL -
ALL INFORMATION WILL BE HELD IN STRICTEST CONFIDENCE

FOR ™ CORPORATION ™ PARTNERSHIP ™ PROPRIETORSHIP
™ INDIVIDUAL ™ INCORPORATED WITHIN LAST 12 MONTHS

_____________________________________________________________________
Name (President)                             Address                                  City                      State      Zip Code

_____________________________________________________________________
Name (Secretary)                            Address                                  City                      State      Zip Code

_____________________________________________________________________
Name (Treasurer)                            Address                                  City                      State      Zip Code

____________________________
Bank Name

________________________________
Bank Address

________________________________
City                                          State     Zip Code
_____________________________
Telephone

_________________________________
Account Representative

_____________________________________________________________________
Name                                              Address                                      City                     State     Zip Code

_____________________________________________________________________
Name                                              Address                                      City                     State     Zip Code

_____________________________________________________________________
Name                                              Address                                      City                     State     Zip Code

_____________________________________________________________________
Name                                              Address                                      City                      State     Zip Code


I, (WE) CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT,
AND THAT WE CAN AND WILL COMPLY WITH YOUR TERMS.
______________
Date		 _______________________
Signature

_______________________
Title

 ________________________
Signature

________________________
Title
__________________________________________
References Checked By                                                Date

__________________________________________
Remarks

__________________________________________
Remark

__________________________________________
Approved By                                                                  Date

 ________________________
Credit Approved By               Date

________________________
Credit Refused By                  Date

________________________
Account Opened By               Date

________________________
Customer Contacted By         Date

 

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1999 Swan Label & Tag
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