Credit Application

PROFILE> Complete this section in full.

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Yes No

 

REFERENCES> Complete this section if applying for 30-day credit terms

Reference #1

 

Reference #2

 

AUTHORIZATION>

The above information is for the purpose of obtaining credit and is warranted to be true. I/We hereby authorize Astley Gilbert to investigate the references listed pertaining to my/our credit for financial responsibility. I/We understand the terms by which Astley Gilbert grants credit requires payment in full within 30 days.