Credit Application
Complete all business, principal, trade reference, and signature details from the DETF Credit App PDF. All phone fields must use the Phone Number type.
Business Information
Business Name
*
Business Address
*
Business City
*
Business State
*
Business Zip
*
Business Telephone #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Business Cell
Please enter a valid phone number.
Format: (000) 000-0000.
Business Email Address
*
example@example.com
Principal / General Partner Information
Principal / General Partner 1 - Name
*
Principal / General Partner 1 - Title
*
Principal / General Partner 1 - Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Principal / General Partner 1 - Address
*
Principal / General Partner 2 - Name
Principal / General Partner 2 - Title
Principal / General Partner 2 - Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Principal / General Partner 2 - Address
Credit and Business Type
Have you ever declared bankruptcy?
Yes
Desired Line of Credit
*
Type of Business
*
Corporation
Partnership
Sole Proprietorship
Other
Type of Business - Other
Local Trade References
Local Trade Reference 1 - Name
*
Local Trade Reference 1 - Address
*
Local Trade Reference 1 - Telephone #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Local Trade Reference 1 - Email
example@example.com
Local Trade Reference 1 - High Credit
Local Trade Reference 1 - Years Active
Local Trade Reference 2 - Name
*
Local Trade Reference 2 - Address
*
Local Trade Reference 2 - Telephone #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Local Trade Reference 2 - Email
example@example.com
Local Trade Reference 2 - High Credit
Local Trade Reference 2 - Years Active
Local Trade Reference 3 - Name
*
Local Trade Reference 3 - Address
*
Local Trade Reference 3 - Telephone #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Local Trade Reference 3 - Email
example@example.com
Local Trade Reference 3 - High Credit
Local Trade Reference 3 - Years Active
Signature and Authorization
Signature of President or CEO
*
President/CEO Title
*
Signature Date
*
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: