.: Application for Credit - V and V Appliance Parts Inc. :.

V and V Appliance Parts Inc. - Credit Application

Please fill out the following form with accurate information. All requests for credit will be reviewed, and you will be contacted by a representative as soon as possible. Thank you for your interest in V and V Appliance Parts Inc.

You may either submit this form electronically, or print it out and mail it to us.

V and V Appliance Parts Inc.
Attn: Credit Department
27 W. Myrtle Ave.
Youngstown, Ohio 44507

NAME OF COMPANY
STREET ADDRESS
CITY
STATE
ZIP
BUSINESS PHONE
PRINCIPAL OWNER'S NAME
TAX EXEMPT NUMBER
HOME ADDRESS
HOME PHONE
YEARS ESTABLISHED
IS BUSINESS INCORPORATED?
BANK AFFILIATION
BANK OFFICER

BUSINESS REFERENCE 1	Name
	Address
	Phone
	Fax

BUSINESS REFERENCE 2	Name
	Address
	Phone
	Fax

Maximum Credit Applied For: $

NOTE: If account is authorized to purchase appliance parts on an open account, be it understood that all purchases will be due and payable by the tenth of the month following the date of purchase. The undersigned official, to induce the granting of credit to the above-named firm, hereby; personally guarantees the company's credit.

By placing your name in this box, you agree to adhere to the aforementioned note, and you are guaranteeing that you are an officer of the applying firm.

Please "sign" here