249 West High Street
Elkton, Maryland 21921-5235
410-398-2800
Fax 410-398-2803

CREDIT APPLICATION

Instructions:
  • Fill Out Form
  • Print Form
  • Fax To The Plasticoid Company: 410-398-2803
  • NOTE: All information must be provided before the application can be processed

BUSINESS INFORMATION:

Date:
  
New Customer Name:
Phone Number:
 
Fax Number:
Street Address:
City:   State:   Zip Code:
E-Mail Address:
Type of Business:   Year(s) Established:
Officer or Principal's Name:   Estimated Monthly Purchase(s):

VENDOR REFERENCES (Complete Information Is Essential):

Firm Name (1):
Street Address:
City:   State:   Zip Code:
Phone Number:   Fax Number:
Firm Name (2):
Street Address:
City:   State:   Zip Code:
Phone Number:   Fax Number:
Firm Name (3):
Street Address:
City:   State:   Zip Code:
Phone Number:   Fax Number:

BANK REFERENCES:

Name of Bank:
Street Address:
City:   State:   Zip Code:
Phone Number:   Contact:

OTHER BACKGROUND INFORMATION:

1. A copy of your most current available financial statement or facsimile acceptable to the credit manager must accompany this application for it to receive full and fair consideration.

2. Please list any other information that should be taken into consideration during our review, and whether or not you have done business with The Plasticoid Company before?
 
Signature: Title:

Return to Plasticoid Home Page