TOP Equipment Houston Area Dealer Credit Application Credit App Form Name of Dealership * Name of Legal Entity * Assumed Name If Applicable Address of Business * Address 1 Address 2 City State/Province Zip/Postal Code Country Business Phone Number * (###) ### #### Business Fax (###) ### #### General Email to Use Point of Contact Name Billing Contact Information Billing Contact Name * Billing Phone * (###) ### #### Billing Contact Email * Billing Address (If Different From Business Address) Address 1 Address 2 City State/Province Zip/Postal Code Country Name of Owner(s) 1 * Title of Owner 1 * Name of Owner(s) 2 Title of Owner 2 Name of Owner(s) 3 Title of Owner 3 Products Interested in Handling * State Resale Certificate Number(s) * Please be sure to fax copies of State Resale Certificate(s) to - 800-863-8673 Bank References Name of Bank * Bank Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Bank Phone Number * (###) ### #### Bank Officer * Type of Account * How Long Banking Here? * Trade References GIVE ONLY NAMES OF THOSE YOU BUY FROM ON OPEN ACCOUNT FOR AT LEAST ONE YEAR Trade Reference Name 1 * Trade Reference Address 1 * Address 1 Address 2 City State/Province Zip/Postal Code Country Trade Reference Phone 1 * (###) ### #### Trade Reference Fax 1 * (###) ### #### Trade Reference Email Address 1 Trade Reference 1 High Credit * Account Number 1 Trade Reference Name 2 * Trade Reference Address 2 * Address 1 Address 2 City State/Province Zip/Postal Code Country Trade Reference Phone 2 * (###) ### #### Trade Reference Fax 2 * (###) ### #### Trade Reference Email Address 2 Trade Reference High Credit 2 * Account Number 2 Trade Reference Name 3 * Trade Reference Address 3 * Address 1 Address 2 City State/Province Zip/Postal Code Country Trade Reference Phone 3 * (###) ### #### Trade Reference Fax 3 * (###) ### #### Trade Reference Email Address 3 Trade Reference High Credit 3 * Account Number 3 Wells Fargo Floor Plan Account Number If you have a Wells Fargo Floor Plan please include your Account Number Do You Own Your Business Location * YES NO Landlord Info If You Do Not Own Your Business Location Please State Name, Address & Telephone of Landlord Business License Number * Tax ID # * Annual Gross Sales * Number of Years This Business * Taxable * YES NO Ownership * Corporation Partnership Proprietorship Statements / Invoices Mailed or Emailed * Mailed Emailed I Acknowledge that I will Fax Tax Returns and State Resale Certificate(s) after clicking the Submit Button * * I Agree Thank you! Please be sure to Fax over your State Resale Certificate(s) to - 800-863-8673 Please be sure to Fax over your State Resale Certificate(s) after hitting the Submit Button to - 800-863-8673
