Customer Credit Application

Firm name *

Address *

City *

State *

Zip *

Country *

Contact Name *

Contact Phone *

Accounting Contact Name *

Accounting Contact Phone *

Federal Tax No.

Resale Tax No.

Business Structure Proprietorship Partnership Corporation

Length of years business has been established

Sign and Return "Authorization to release Bank References"

Bank Name

Bank Account Number *

Bank Contact Name

Title

Phone Number

Fax Number

Please provide trade references from customers with whom you are currently doing business with relationships which are equal to or greater than the amount of the credit line you are requesting below.

Name

Contact

Address

Phone Number

City

State

Zip

Fax Number

Country

Name

Contact

Address

Phone Number

City

State

Zip

Fax Number

Country

Credit Term Requested

Maximum Credit Line Requested

DUNS Number

If credit is extended, I/we agree to pay all debts incurred within the terms of sale. I/we further expressly agree to pay reasonable collection costs and/or attorney's fees incurred in connection with the collection of this account, if it becomes delinquent.

Signature

Dairy Ice
Cream

Non-Dairy / Vegan
Ice Cream

Ice &
Sorbet