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 -COMMERCIAL CREDIT APPLICATION (cont'd)-

Account Name:  _____________________________________________________________________________________

Address: __________________________________________________  City & Zip Code:___________________________

Mailing Address: _____________________________________________________________________________________

Phone Number:_______________________________________   Fax Number: ____________________________________

For Corporation:

A) Date Incorporated:_________________ President:__________________________________
   
  Vice Pres:__________________________________
   
(B) Name of Parent Co:_____________________________________________________________________

For Partnerships and Sole Proprietorships:

(A) Date-Start of Business:_____________________  
   
(B) Owners Name:____________________________ SS#:_______________________________
   
     Owners Name:____________________________ SS#:_______________________________

Credit References:

Name Address Phone Number
 
1._______________________________________________________________________________________
 
2._______________________________________________________________________________________
 
3._______________________________________________________________________________________
 
4._______________________________________________________________________________________

P.O. Required?_____yes_____no  Resale?_____yes_____no (If yes, include Resale Card)

Please list those persons authorized by your company to sign for purchases:___________________

______________________________________________________________________________________________________

______________________________________________________________________________________________________

Have you ever applied for credit with MARSHALL'S INDUSTRIAL HARDWARE, INC. under this name or another name? 
If yes, under what name?___________________________________________________