Business Contact Information

Example: 432-563-3332

Example: 432-563-3340

Owners / Officers
Business and Credit Information

Example: 432-563-3332

Exampe: 432-563-3340


*If so attach tax exemption certificate

Bank Information
Business / Trade References

Must have a minimum of three (3) references in order to process your credit application.

Business / Trade Reference #1
Business / Trade Reference #2
Business / Trade Reference #3
Information Required by your company on delivery tickets to ensure prompt payment:

Check all the products that are you interested in either purchasing or renting

  1. All payments are due 30 days from the receipt of the invoice. Invoices are considered past due after 30 days and will be subject to an interest charge of 18% per annum or 1.5% per month for each month the balance due remains unpaid.
  2. Claims arising from invoices must be made within 30 calendar days.
  3. By submitting this application, you authorize Milford to make inquiries into the banking and business/trade references that you have supplied.
  4. Annual CPA generated Financial Statements or personal guarantee MAY be required if the credit limit requested is higher than credit reference’s balance history.

If you have read the above statement, please check yes if you agree the agreement above.

E - Signatures

By typing my name in the following box I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing this credit application and its information.

The Individual that is signing this credit application MUST be an owner/officer of the company in order to complete this application.

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