credit application
(877) 627-1596 / (949) 585-9555

To apply for credit with Stedman Computer Systems, print out this page and fax the completed credit application to (949) 585-9550.  Any information provided will be held in strict confidence.  We look forward to serving you.

Company Information
Business______________________________________________________________

Legal Form (Corp, Sole Proprietor, Partnership)_______________________________

Terms Requested_______________________________________________________

Street Address_________________________________________________________

City, State, Zip_________________________________________________________

Telephone (      ) ___________________       Fax (       )_______________________

Contact __________________       Principal Officer___________________________

Annual Sales Volume_______________       Number of Employees_______________

Bank Reference
Bank____________________________       Account#_________________________

Street Address_________________________________________________________

City, State, Zip_________________________________________________________

Telephone_______________________       Contact ___________________________


 

 

Trade References
 1. Name_________________________       Account #_________________________

Address, City, State, Zip__________________________________________________

Telephone_______________________       Contact ___________________________

2. Name_________________________       Account #_________________________

Address, City, State, Zip__________________________________________________

Telephone_______________________       Contact ___________________________

3. Name_________________________       Account #_________________________

Address, City, State, Zip_________________________________________________

Telephone_______________________       Contact ___________________________

The credit information provided in this application is true and complete to the best of my knowledge.  I hereby authorize you to investigate our credit and to obtain such other information as may be necessary to determine credit worthiness. 

Name___________________________       Title_______________________________

 

Signature________________________       Date_______________________________

 

 

 

 

 


© 2006 Stedman Computer Systems
(877) 627-1596 (949) 585-9555