Credit Application 2026
NEIL JONES FOOD COMPANY
Section 1: Company Information
Business Information
Date
*
-
Month
-
Day
Year
Date
Business Name
*
DBA
Dunn & Bradstreet (D&B#)
Company Web Address
Type of Ownership
Please Select
Sole Owner
Corporation
Proprietorship
Parntership
LLC
Ownership Type
Sole Owner
Corporation
Proprietorship
Partnership
LLC
Owner Name
Owner Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Owner Percentage Ownership
President Name
President Phone
Please enter a valid phone number.
Format: (000) 000-0000.
President Percentage Ownership
No. of Employees
Estimated Annual Sales
Section 2: Applicant
Applicant
Applicant Name
*
Applicant Email Address
*
example@example.com
Applicant Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Applicant Fax
Please enter a valid phone number.
Format: (000) 000-0000.
Applicant E-mail (alternate)
example@example.com
Section 3: Account Payable & Bill Contact
Account Payable & Bill Contact Information
Business Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Business Fax
Please enter a valid phone number.
Format: (000) 000-0000.
Business Email Address
*
example@example.com
Billing - Company Name
*
Billing - Contact Name
*
Billing - Addresss
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Billing - Email Address
*
example@example.com
Billing - Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Billing - Fax
Please enter a valid phone number.
Format: (000) 000-0000.
AP Contact / Phone
*
AP Contact / Payment Inquiries Contact Email Address
*
example@example.com
Require Monthly Statement
Yes
No
Date Established (Current Owner)
-
Month
-
Day
Year
Date
Section 4: Trade References
Section 4: Trade References
Trade References
*
Section 5: Bank Reference
Bank Reference
*
Section 6: Order & Ship To Information
Section 6: Order Information & Ship To Information
General Description of products to be purchased
Desired Credit Limit
*
Accept Partial Shipments
Yes
No
Ship to is same as above
Ship to:
Business Name
Street Address
City
State
Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Ship To - Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Ship To - Email Address
example@example.com
Neil Jones Sales Representative
Please Select
Angie Mendez-Lopez
Agata Willis
Mark La Bar
Mark Mahoney
Peter Tenny
Chris Casey
Ed Astley
Steve Hundt
John Kor
Mark Stegeman
Broker / Other
Broker Name / Other
*
Orders will be placed by
*
Please Select
Sales Representative
Broker
Other
Section 7: File Upload
File Upload
Browse Files
Drag and drop files here
Choose a file
Credit References / Financials / Other Documents
Cancel
of
Section 8: Terms & Conditions
Officer/Principal Signature
*
Officer/Principal Printed Name
*
Officer/Principal Signature Date
*
-
Month
-
Day
Year
Date
Please verify that you are human
*
Submit Application
Submit Application
Should be Empty: