Form J - Credit Limit Adjustment Form
Agency Name
*
Agency Number
*
Current Credit Limit
*
Requested Credit Limit
*
Preferred Method of Account Resolution (check one)
*
Agency Check
Agency Credit Card
Credit Account
Please explain the reason for the request on the lines provided below:
*
Additional Comments/Information
Please list authorized food distribution program personnel:
*
Authorized Individual
*
First Name
Last Name
Submit
Should be Empty: