E & E INDUSTRIES	Phone:  559-562-9776
360 N. Mt. Vernon – P.O. Box 729	Fax:  559-562-1765
Lindsay, CA 93247	Email:  info@EandEindustries.com

Credit Application

Applicants Business Name: 	
Address: _____________________________________County: 	
Billing Address: 	
Telephone: ___________________Fax: ____________________e-mail: 	
Nature of Business: 	

Business Entity:__Corporation__Partnership__Sole Proprietor__Other-Explain
Year Business Started: _______________
Employer’s ID No. _______________Seller’s Permit # _________________State: 	

Principal Owners or Stockholder
Names				Address				Soc. Sec. No.

	

Trade References/Creditors:  (List at least three references)

Name					Address			Phone		Fax

	

Name of Bank: ____________________Branch: _____________City/State: 	

Type of Account: __________________Bank Account # _____________Phone: 	

Signed __________________________________Title 	

Printed Name