England Finance

Jun 12 2017

Blank Credit Reference Form #rewards #credit #card


#credit reference
#

To: _______________________________________________________ Fax: _______________________________

The following customer has listed you has a trade credit reference. Would you please complete this

form and return it to us to:

Address: ______________________________________________________________________________________

If you have any questions you may contact our Credit Department.

Customer Requesting Reference:

Name: ________________________________________________________________________________________

Address: ______________________________________________________________________________________

City / State / Zip: _______________________________________________________________________________

Phone Number: ________________________________________________________________________________

Reference Information:

Date account opened: ___/___/_____

Terms: __ Net __ Days __ COD __ Prepay

High Credit: _______________________

Current Balance: ___________________

Amount past due: __________________

Average Days to Pay: _______________

Date of last order: ___/___/_____

Additional comments or information: _______________________________________________________________

_____________________________________________________________________________________________

_____________________________________________________________________________________________

Signature: ___________________________________________________________________Date: ___/___/_____

Print Name: ___________________________________________________________________________________

Title: _________________________________________________________________________________________


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