C R E D I T A P P L I C A T I O N Company Name_________________________________________________________________________________________ Address _______________________________________________________________________________________________ City ___________________________________ State_____________________________________Zip___________________ Phone __________________________________________ Email ________________________________________________ Years In Business________________________________________________________________________________________ OWNER'S INFORMATION Corporation Incorporated within the past 12 months Partnership Proprietorship Principal _______________________________________________________________________________________________ Name Address BANK REFERENCES _______________________________________________________________________________________________________ Bank Name Contact _______________________________________________________________________________________________________ Address City State Zip _______________________________________________________________________________________________________ Account Number Phone REFERENCES _______________________________________________________________________________________________________ Name Phone Number Fax _______________________________________________________________________________________________________ Name Phone Number Fax _______________________________________________________________________________________________________ Name Phone Number Fax _______________________________________________________________________________________________________ Name (Please Print) Title _______________________________________________________________________________________________________ Signature Date EMAIL INFO@SMSSUPPLIES.COM WEB WWW.SMSSUPPLIES.COM 162 SPENCER STREET BROOKLYN, NY 11205 TEL. 718.676.1820 FAX 718.676.1821 S M S C R E D I T A P P L I C A T I O N S M S C R E D I T A P P L I C A T I O N _________________________________________________________________________________________ S M S _________________________________________________________________________________________ _______________________________________________________________________________________________ S M S _______________________________________________________________________________________________ ___________________________________ S M S ___________________________________ State S M S State_____________________________________ S M S_____________________________________ __________________________________________ S M S __________________________________________ Years In Business S M S Years In Business________________________________________________________________________________________ S M S ________________________________________________________________________________________ OWNER'S INFORMATION S M S OWNER'S INFORMATION S M S S M S S M S S M S S M S S M S S M S S M S S M S S M S S M S S M S S M S S M S S M S S M S S M S S M S Corporation S M S Corporation Corporation S M S Corporation S M S Partnership S M S Partnership A L L BANK REFERENCES A L L BANK REFERENCES A L L A L L A L L _______________________________________________________________________________________________________ A L L _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ A L L _______________________________________________________________________________________________________ Address A L L Address _______________________________________________________________________________________________________ A L L _______________________________________________________________________________________________________ Account Number A L L Account Number REFERENCES A L L REFERENCES A L L A L L A L L A L L A L L A L L A L L A L L A L L A L L _______________________________________________________________________________________________________ A L L _______________________________________________________________________________________________________ Name A L L Name A L L Name Name A L L Name Name _______________________________________________________________________________________________________ A L L _______________________________________________________________________________________________________ Name A L L Name R I G H T S _________________________________________________________________________________________ R I G H T S _________________________________________________________________________________________ _______________________________________________________________________________________________ R I G H T S _______________________________________________________________________________________________ _____________________________________ R I G H T S _____________________________________Zip R I G H T S Zip___________________ R I G H T S ___________________ ________________________________________________ R I G H T S ________________________________________________ ________________________________________________________________________________________ R I G H T S ________________________________________________________________________________________ Incorporated within the past 12 months R I G H T S Incorporated within the past 12 months Proprietorship R I G H T S Proprietorship _______________________________________________________________________________________________ R I G H T S _______________________________________________________________________________________________ _______________________________________________________________________________________________________ R I G H T S _______________________________________________________________________________________________________ WWW.SMSSUPPLIES.COM R I G H T S WWW.SMSSUPPLIES.COM R I G H T S R E S E R V E D ___________________ R E S E R V E D ___________________ ________________________________________________ R E S E R V E D ________________________________________________ ________________________________________________________________________________________ R E S E R V E D ________________________________________________________________________________________ _______________________________________________________________________________________________ R E S E R V E D _______________________________________________________________________________________________ Address R E S E R V E D Address _______________________________________________________________________________________________________ R E S E R V E D _______________________________________________________________________________________________________ Contact R E S E R V E D Contact _______________________________________________________________________________________________________ R E S E R V E D _______________________________________________________________________________________________________ City R E S E R V E D City _______________________________________________________________________________________________________ R E S E R V E D _______________________________________________________________________________________________________ Phone R E S E R V E D Phone R E S E R V E D _______________________________________________________________________________________________________ R E S E R V E D _______________________________________________________________________________________________________ Phone Number R E S E R V E D Phone Number _______________________________________________________________________________________________________ R E S E R V E D _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ R E S E R V E D _______________________________________________________________________________________________________ _______________________________________________________________________________________________________ R E S E R V E D _______________________________________________________________________________________________________