Credit Application


Phone: 828-733-3731


Fax: 828-733-1053

149 New Vale Road

Newland, NC 28657

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Date _____________________




Name _________________________________________


Company Name_________________________________


Address________________________________________


City ___________________________________________


State_________________________ Zip______________


Years at this address_____________________________


Ownership




If incorporated within last 12 months


Name of Principals, Address, Zip, Phone


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Finance

Bank_______________________________________________


Bank Address________________________________________


Bank Officer or Dept._________________________________


Bank Phone _________________________________________


References: Business Name, address, phone, and FAX #

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Date __________________________


Signature __________________ Name _____________


Title_________________________________________


                   print this form, fill out and fax to                                                                   

                               (828) 733-1053

Check here.

Individual

Partnership

Corporation