F.B. McIntire Equipment Company, Inc. 
Phone 817.429.1750 Fax 972.579.1603
3025 S. Cravens Road                          
Fort Worth, Texas 76119      
Credit Application (Must be completed and reviewed before account established)
 Billing /Shipping Information												

Legal Company Name: __________________________________Contact Person: ______________________________
Address: __________________________________________________________________________________________
City: _________________________________State:_______________ County: __________________Zip:_____________
Type of Business: ___________________________________Year Business opened: _____________________________
Phone: _____________________________Fax:_____________________Email:_________________________________
Federal I.D. or S.S. #:_____________________________Principal's Name: _____________________________________
Is a P.O. required? ____No _____Yes            Are you tax exempt? ____No ____Yes (Please attach certificate)
Legal Entity:  	 Corporation________		 Partnership_______		 Ind. Prop._________ Other_______ 
Accounts Payable Name_______________________________ Phone #________________________________________ 
If you prefer to receive invoices electronically, please provide e-mail __________________________________________
 
Bank Information													

Bank: ____________________________________________________________________________________________
Address: __________________________________________________________________________________________
City: ________________________________State:_______________________Zip:_______________________________
Phone: _____________________________________Date Account opened: ___________________________________
Proprietors, Partners, or Officers - (All must be included, use additional sheets if necessary)				

Name: _______________________________________   Title: ______________________________________________

Name: _______________________________________   Title: ______________________________________________

Name: _______________________________________   Title: ______________________________________________

Trade/Credit References												

Reference 1:_____________________________________________Contact:___________________________________
Phone No.:_________________________________________ Email/Fax No.:___________________________________
Reference 2:_____________________________________________Contact:___________________________________
Phone No.:_________________________________________Email/ Fax No.:___________________________________
Reference 3:_____________________________________________Contact:___________________________________
Phone No.:_________________________________________Email/ Fax No.:___________________________________

Credit Terms/Agreement      	:

The information and statements in this application are true and complete, and they are made for the purpose of inducing F.B. McIntire Equipment Company, Inc. to establish an open account line of credit.
TERMS
I/We agree to pay outstanding invoices within the terms of NET 30 days. I/We agree that if payment of said account is not made on or before the due date(s), and the account is placed in the hands of an attorney for collection, or suit is brought on the same, or the account is collected through probate or bankruptcy proceedings, an additional and reasonable amount shall be added to the account to cover court costs and attorney’s fees.
AGREEMENT
By submitting this application, we/I authorize F.B. McIntire Equipment Company, Inc. to make inquiries into the banking and business/trade/credit references that we have supplied to your company.

Signature: __________________________________________________________________Date:___________________

Printed Name: ______________________________________________________________________________________