Copyright Envision Corporation. 2002. All rights reserved.

Protected by the copyright laws of the United States & Canada and by nternational treaties. ! S ""E#A" A$% S!& C!"' P&() * !E% !( % S!& *U!E+ PU*" S)+ (,,E& ,(& SA"E+ " CE$SE (& SU*" CE$SE+ # -E (& % SC"(SE !( A$' (!)E& PA&!'+ !) S P&(%UC! $ )A&% C(P' (& % # !A" ,(&.. A"" (,,E$%E&S / "" *E SUE% $ A C(U&! (, "A/.

BUSINESS CREDIT APPLICATION

Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright laws of the United States & Canada and by international treaties. ! S ""E#A" A$% S!& C!"' P&() * !E% !( % S!& *U!E+ PU*" S)+ (,,E& ,(& SA"E+ " CE$SE (& SU*" CE$SE+ # -E (& % SC"(SE !( A$' (!)E& PA&!'+ !) S P&(%UC! $ )A&% C(P' (& % # !A" ,(&.. A"" (,,E$%E&S / "" *E SUE% $ A C(U&! (, "A/.

Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright laws of the United States and Canada and by international treaties. ! S ""E#A" A$% S!& C!"' P&() * !E% !( % S!& *U!E+ PU*" S)+ (,,E& ,(& SA"E+ " CE$SE (& SU*" CE$SE+ # -E (& % SC"(SE !( A$' (!)E& PA&!'+ !) S P&(%UC! $ )A&% C(P' (& % # !A" ,(&.. A"" (,,E$%E&S / "" AU!(.A! CA""' *E SUE% $ A C(U&! (, "A/.

Name/Address
"ast0 $a1e of *2siness0 Address0 City0 State0 4 P0 Phone0 ,irst0 .iddle nitial0 !itle !a3 .%. $21ber

Company Information
!ype of *2siness0 "egal ,or1 Under /hich *2siness (perates0 State5Province0 f %ivision5S2bsidiary+ $a1e of Parent Co1pany0 Corporation n *2siness Since0 Partnership n *2siness Since0 !itle0 4 P0 !itle0 4 P0 Phone0 Phone0 Proprietorship

$a1e of Co1pany Principal &esponsible for *2siness !ransactions0 Address0 City0 State0

$a1e of Co1pany Principal &esponsible for *2siness !ransactions0 Address0 City0 State0

Bank References
nstit2tion $a1e0 Chec6ing Acco2nt 70 Address0 nstit2tion $a1e0 Savings Acco2nt 70 Address0 nstit2tion $a1e0 )o1e E82ity "oan0 Address0 "oan *alance0

Phone0

Phone0

Phone0

Trade References
Co1pany $a1e0 Contact $a1e0 Address0 Co1pany $a1e0 Contact $a1e0 Address0 Co1pany $a1e0 Contact $a1e0 Address0

Phone0 Acco2nt (pened Since0 Credit "i1it0 C2rrent *alance0

Phone0 Acco2nt (pened Since0 Credit "i1it0 C2rrent *alance0

Phone0 Acco2nt (pened Since0 Credit "i1it0 C2rrent *alance0

 Copyright Envision Corporation. 2002. All rights reserved. Protected by the copyright laws of the United States & Canada and by nternational treaties. ! S ""E#A" A$% S!& C!"' P&() * !E% !( % S!& *U!E+ PU*" S)+ (,,E& ,(& SA"E+ " CE$SE (& SU*" CE$SE+ # -E (& % SC"(SE !( A$' (!)E& PA&!'+ !) S P&(%UC! $ )A&% C(P' (& % # !A" ,(&.. A"" (,,E$%E&S / "" *E SUE% $ A C(U&! (, "A/.

inancia! Information
Company Tota! Assets Income Company Tota! Lia"i!ities Ann#a! Net 'es $o Amo#nt of Credit Re$#ested%

)ave yo2 or yo2r officers or affiliates ever filed a petition in ban6r2ptcy9 s yo2r co1pany s2b:ect to any litigation9 'es $o

f so+ describe0

/e declare that the above infor1ation is tr2e+ correct and co1plete and is given to ind2ce the Co1pany to e3tend credit. /e a2thori;e the Co1pany to 1a6e s2ch credit investigation as the Co1pany sees fit+ incl2ding contacting the above trade references and ban6s and obtaining credit reports. /e a2thori;e all trade references+ ban6s and credit reporting agencies to disclose to the Co1pany any and all infor1ation concerning the financial and credit history of 1y co1pany and 1yself0 have read the ter1s and conditions stated below and agree to all of those ter1s and conditions.

$a1e of Co1pany0

A2thori;ed Signat2re0 !itle0 Printed $a1e0