Company name
Address
City StateZip
Phone Fax  DUNS #
Check one: Corporation     Partnership     Sole Proprietor
Type of business Years in business
Tax exempt? Yes     NoTax exempt #  Please attach sales tax exempt certificate
Principal owner/officer
Name Title
Address
City StateZip
Phone Fax  
Accounts payable supervisor Phone  
Bank Name Account Number
Address
City StateZip
Phone Fax  
Bank officer Extension  
Trade reference #1
Name
Address
City StateZip
Phone Fax  
Trade reference #2
Name
Address
City StateZip
Phone Fax  
Trade reference #3
Name
Address
City StateZip
Phone Fax  
Authorization:

The above information is submitted for the purpose of obtaining credit. Buyer authorizes Universal Printing Company to make such inquiries as necessary to obtain credit information and authorizes Buyer's bank and/or suppliers to release information regarding Buyer's account(s).

Name TitleDate
Signature
Your salesperson
Please fax credit application to 314-771-7987