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:

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