LH Printing and Supplies
Online Credit Application 		 
         
Company Information
 
Company Name
   
 
Name of Owner
    
 
Tax Exempt Account
   Yes  
 
Tax Exempt Number
   
 
Billing Address
    
 
Street Address
   
 
City
   
 
State
   
 
Zip
   
 
Phone Number
   
 
Fax Number
    
 
E Mail Address
   
 
Accounts Payable Contact
    

Shipping Address
 
Street Address
   
 
City
   
 
State
   
 
Zip
   
 
Phone Number
   
 
Fax Number
    

Credit Information
 
Monthly Credit Requested
   
 
Type of Business
    
 
Years in Business
    
 
P O Reqiured
   Yes, If checked  

Bank References
 
Name
   
 
Name of Bank Officer
   
 
Title of Bank Officer
   
 
Street Address
   
 
City
   
 
State
   
 
Zip
   
 
Loan Account Number
   
 
Checking Account Number
   

Trade References (Excluding Credit Cards)
 
Trade Reference #1
     
 
Name
    
 
Address
    
 
City
   
 
State
   
 
Zip
   
 
Phone
   
 
Fax
   
 
Contact Name
    
 
Trade Reference #2
      
 
Name
    
 
Address
    
 
City
   
 
State
   
 
Zip
   
 
Phone
   
 
Fax
   
 
Contact Name
    
 
Trade Reference #3
      
 
Name
    
 
Address
    
 
City
   
 
State
   
 
Zip
   
 
Phone
   
 
Fax
   
 
Contact Name