Gazaway Lumber Credit Application

Gazaway Lumber Credit Application

Complete this secure credit application using the fields from the referenced PDF. Required fields are marked by the original document; sensitive information is protected.
Applicant Information
Full Legal Name

First NameMiddle NameLast Name
Mailing Address
City
State
ZIP Code
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Date of Application

MonthDayYear
Date
Account Type
Federal Tax ID / EIN
Social Security Number
Date of Birth

MonthDayYear
Date
Employer or Business Name
Length of Time at Current Employment / Business
Position or Title
Business Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
AP / Billing Contact Name
Construction Project and Loan Information
Will charges be used on a construction project you own?
Financed by a construction loan?
Physical Address of Project

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Construction Loan Amount ($)
Lender Name
Lender Contact Name

First NameMiddle NameLast Name
Lender Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Lender Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Loan Approval Date

MonthDayYear
Date
Trade References
Reference 1 Company/Creditor Name
Reference 1 Account Number
Reference 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 Company/Creditor Name
Reference 2 Account Number
Reference 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3 Company/Creditor Name
Reference 3 Account Number
Reference 3 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Personal References
Personal Reference 1 - Full Name

First NameMiddle NameLast Name
Personal Reference 1 - Relationship
Personal Reference 1 - Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Personal Reference 2 - Full Name

First NameMiddle NameLast Name
Personal Reference 2 - Relationship
Personal Reference 2 - Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Purchasers
Authorized Purchaser 1 Full Name

First NameMiddle NameLast Name
Authorized Purchaser 1 Phone Number / Employee ID
Authorized Purchaser 2 Full Name

First NameMiddle NameLast Name
Authorized Purchaser 2 Phone Number / Employee ID
Authorized Purchaser 3 Full Name

First NameMiddle NameLast Name
Authorized Purchaser 3 Phone Number / Employee ID
Authorized Purchaser 4 Full Name

First NameMiddle NameLast Name
Authorized Purchaser 4 Phone Number / Employee ID
Terms, Signature, and Authorization
Non-Corporate Applicant Signature
Printed Name

First NameMiddle NameLast Name
Date

MonthDayYear
Date
Corporate/Business Applicant Signature
Corporate Printed Name

First NameMiddle NameLast Name
Corporate Date

MonthDayYear
Date
For Gazaway Lumber Use Only
Date Received

MonthDayYear
Date
Account Number
Credit Score
Credit Report Date

MonthDayYear
Date
Credit Limit
Date Approved

MonthDayYear
Date
Approved By
Should be Empty:

Gazaway Lumber Credit Application

Applicant Information

Construction Project and Loan Information

Trade References

Personal References

Authorized Purchasers

Terms, Signature, and Authorization

For Gazaway Lumber Use Only