Credit Application
User Manual: credit-application
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NSCA, LLC A COMPANY SPECIALIZING IN QUALITY RECONDITIONED ELECTRONIC TEST AND MEASUREMENTT EQUIPMENT 7901 Beechcraft Avenue Suites M & N Gaithersburg, Maryland 20879 Office: (301)527-9200 Fax: (301)527-9203 www.nscainc.com CREDIT APPLICATION (PLEASE TYPE OR PRINT CLEARLY) FIRM NAME_______________________________ TYPE OF BUSINESS_________________________ STREET ADDRESS_____________________________________ PHONE#________________________ CITY/STATE/ZIP_________________________________________ FAX#________________________ RESALE TAX #_________________________________ FOR THE STATE OF:____________________ CHECK ONE: CORPORATE____; LLC____; PARTNERSHIP_____; SINGLE PROPIETORSHIP____ ACCOUNTS PAYABLE CONTACT________________________ PHONE # ______________________ PRINCIPLE OFFICER__________________________________ CONTACT_______________________ RESIDENT AGENT_____________________ ADDRESS______________________________________ BANK REFERENCE BANK NAME__________________________________________________________________________ STREET ADDRESS_____________________________________ PHONE#________________________ CITY/STATE/ZIP_________________________________________FAX#_________________________ ACCOUNT#_____________________________________ CHECKING____ SAVINGS____ LOAN____ BUSINESS REFERENCES 1) FIRM NAME______________________________________ CONTACT_______________________ STREETADDRESS__________________________________ PHONE#________________________ CITY/STATE/ZIP______________________________________ FAX#________________________ ACCOUNT#___________________________ 2) FIRM NAME______________________________________ CONTACT_______________________ STREETADDRESS__________________________________ PHONE#________________________ CITY/STATE/ZIP______________________________________ FAX#________________________ ACCOUNT#___________________________ 3) FIRM NAME______________________________________ CONTACT_______________________ STREETADDRESS__________________________________ PHONE#________________________ CITY/STATE/ZIP______________________________________ FAX#________________________ ACCOUNT#___________________________ CREDIT LINE REQUESTING $_________________________ SIGNITURE BELOW AUTHORIZES RELEASE OF CREDIT INFORMATION OFFICER'S SIGNATURE___________________________________ TITLE_______________________ Note: This application will take approximately one week for processing, once the completed application has been received. Applications that are not complete cannot be processed and will be returned.
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