Credit application for corporate accounts CALL (313) 522-5200 Corporate Credit Step 1 of 5 20% Company InformationLegal Business Name(Required)DBA (Doing Business As) Name (if applicable)Business AddressPhone NumberWebsite URLYears in BusinessTax ID / EINEmail(Required) Type of Business (Corporation, LLC, Partnership, Sole Proprietorship)CorporationLLCPartnershipSole Proprietorship Billing & Contact InformationBilling Address (if different from business address)Billing Contact NameBilling Contact Phone NumberUntitledBilling Contact Email Credit Request DetailsRequested Credit AmountEstimated Monthly Purchases Banking InformationBank NameBank AddressAccount Number (last 4 digits only for security)Bank Contact NameBank Contact Phone Number Trade References (At least two)Reference 1Company Name 1Contact Name 1Phone Number 1Email Address 1Years Doing Business Together 1Reference 2Company Name 2Phone Number 2Email Address 2Years Doing Business Together 2 Owner / Officer InformationOwner / Officer NameTitleOwner Phone NumberEmail AddressAuthorization & AgreementConsent(Required) I authorize the release of credit informationDate(Required) MM slash DD slash YYYY Signature(Required)CAPTCHANameThis field is for validation purposes and should be left unchanged.