Confidential Bank Information Release Form

Confidential Bank Information Release Form
Date

MonthDayYear
Date
Bank
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
Account Number
The undersigned has entered into an application for credit with Best Line Oil Company and its affiliated companies. Please consider this an irrevocable authorization to release information regarding this customer. All information obtained will be held in strict confidence.

Sincerely,

Best Line Oil Co. Inc.

Twila S. Hensel / Credit Manager
Customer
DBA
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Fax Number
Please enter a valid phone number.
Email
example@example.com
Signature

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