Credit Application

Billing Information:

*Company Name:

*Contact:

*Mailing Address

*City:

*State:

*Zip:

Shipping Address If Different From Mailing Address:

*Telephone:

Fax:

*Email:

Web Site:

General Business Information:

Type of Business:

*

Sole Proprietorship

Partnership

Corporation

*Years In Business:

Years of Incorporation:

State of Incorporation:

Federal Tax Id:

or SSN#:

State Tax Id Number (WA)

Officer's Name:

Title:

Officer's Name:

Title:

Accounts Payable Contact:

Purchasing Contact:

Bank Reference:

Bank Name:

Bank Address:

Officer Handling:

Bank Phone:

Checking Account #:

Business Credit References (list a minimum of three):

Reference 1/Account #:

*Email:

Address:

Reference 2/Account #:

*Email:

Address:

Reference 3/Account #:

*Email:

Address:

Credit Limit Requested:

Signed:

We hereby authorize the above listed Bank and Trade References to release information to Rural Energy Enterprises, Inc. For use in the evaluation of this account request.

Signature:

Printed Name:

Title:

Date:

Company Name:

REE requires a signed Purchasing Terms and Conditions Agreement for all credit accounts.

Billing Information:

General Business Information:

Bank Reference:

Business Credit References (list a minimum of three):

Signed:

Corporate Information

Customer Support

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Credit Application

Billing Information:

General Business Information:

Bank Reference:

Business Credit References (list a minimum of three):

Signed:

Corporate Information

Customer Support

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Stay Connected