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Credit Application

Business Name:
Date:
Street Address:
City:
State:
Zip:
Phone:
Home Office:
(If other than above)
Type of Business: Corporation   Partnership
Proprietorship   Franchise
Date Business Started:

Description of Business:

Ownership

1. Name:
Social Security No:
Home Address:
Telephone:
Position or Title:
   
2. Name:
Social Security No:
Home Address:
Telephone:
Position or Title:
  
3. Name:
Social Security No:
Home Address:
Telephone:
Position or Title:

If living at the above address less than one year, please give previous address.


Bank References

1. Banks:
Name:
Address:
Type of A/C:
Account Number:

Trade References

1. Name:
Address:
2. Name:
Address:
3. Name:
Address:

How much credit are you applying for?
Who should we contact regarding payments?
Name:
Phone:

Remarks:

      


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Reading Eagle Press

P.O. Box 582, Reading, PA 19603-0582
340 Court Street, Reading, PA 19601
1.800.633.7222 ext. 5180 or locally at 610.371.5180

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