Dahls Equipment Rentals Credit Application

CREDIT APPLICATION
Business Information Disclaimer:
For the purpose of obtaining merchandise and rental equipment on credit, the following made in writing is warranted to be true, intending that you should rely on the same as correct. The applicant hereby authorizes Dahl's Equipment Rentals Inc., and/or its agents to whom this application is made, to investigate/research the references listed herein to ascertain the undersigned personnel, partnership, or corporate credit and financial information.

Contact Name: _______________________ Applicant: ____________________________
Business Name: ___________________________________________________________
Address: ____________________________________________________________
Street Address: (if different) ____________________________________________________
Phone No.: __________________________ Fax No.: _____________________________
Business Type: (check one)
Corporation Partnership Proprietorship Federal Tax I.D. No: ______________
Please List ALL Owners and/or Corporate Officers:
____________________________________ ____________________________________
Print Name Print Title
____________________________________ ____________________________________
Print Name Print Title
____________________________________ ____________________________________
Print Name Print Title
Date Business Started: ___________________ Current Owners Since: ___________________
Former Employment of Owner(s) if Business is Less Than 2 Years Old:
____________________________________ ____________________________________
Company Name From: (month/year)              To: (month/year)
____________________________________ ____________________________________
Company Name From: (month/year)              To: (month/year)
____________________________________ ____________________________________
Company Name From: (month/year)              To: (month/year)
Contractor's Licenses Held:
State Classification License No.: Name Issued Under
_____ _______________________ ___________ _____________________________
_____ _______________________ ___________ _____________________________
_____ _______________________ ___________ _____________________________
Bank Information:
Bank Name: _______________________________ Branch: _______________________
Branch Address: ____________________________________________________________
Account Rep. Name: ____________________________ Phone No: ___________________
Checking Account Savings Account Account Number: _______________________
Checking Account Savings Account Account Number: _______________________
Credit Information:
Please list credit references with complete company name, address, phone number, and contact:
____________________________________ ____________________________________
Company Name Company Name
____________________________________ ____________________________________
Address Address
____________________________________ ____________________________________
City, State, Zip Code City, State, Zip Code
____________________________________ ____________________________________
Contact Name and Fax Number Contact Name and Fax Number
How Did You Hear About Our Company?
Yellow Pages (which one?) ____________ Blue Book ThomasNet SDS Communications
Dahls Salesperson (name) ___________________ Internet (search engine) ________________
Agreement:
The undersigned agrees to all the terms and conditions of sale. Terms and conditions are subject to change without notice. Purchaser agrees to pay all costs of collection, including court costs and all reasonable attorney's fees in case suit or collection action is commenced to collect part or all of the balance on this account. Payment terms are net 30 days, and finance charges are accrued at 1.5% per month on any balance owing past 30 days.
Company Name: _____________________________________ Date: _______________
Print Name: _____________________________ Title: ____________________________
Signature: _________________________________________________________________