Business Credit Application Form

  • APPLICANT'S INFORMATION

  • OWNERSHIP | OFFICER INFORMATION

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  • BILLING INFORMATION | ACCOUNTS PAYABLE

  • PRIMARY BANK REFERENCE

  • TRADE REFERENCES

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  • DISCLOSURES AND SIGNATURE CONFIRMATION

  • I hereby certify that the information contained herein is complete and accurate. This information has been furnished with the understanding that it is to be used to determine the amount and condition of the credit to be extended to the company. Furthermore, I hereby authorize the financial institutions listed in this credit application to release necessary information to Carolina Brick | Carolina Ready Mix for which credit is being applied and in order to verify the information contained herein.
  • Should you have any questions, you may reach Kyle Curtis at: 704.225.8117, Ext. 129. Email is kyle@carolinabrick.com.
 

Verification