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CAMPBELL, INC. – CREDIT APPLICATION
AND AGREEMENT
This
Application is for use ONLY for business / commercial customers and
is subject to approval and acceptance by Campbell, Inc. (“CI”)
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BUSINESS INFORMATION
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Business Name
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Federal I.D. No.
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Years in business
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Street Address
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City
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State
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Zip
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Business Phone
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Type of Business Activity |
Parent Corporation |
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Type of Business (Sole proprietor, Partnership, corporation,
LLC) |
If
LLC – Member Managed or Manager Managed:
If
Manager Managed- Name of Manager: |
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Accts. Payable Contract |
Title |
Phone |
FAX# |
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PRINCIPALS
(FILL OUT THIS SECTION FOR CORPORATIONS, LLCS, AND
PARTNERSHIPS)
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Name |
Title |
Social Security No. |
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Name |
Title |
Social Security No. |
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Name |
Title |
Social Security No. |
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Name |
Title |
Social Security No. |
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PERSONAL INFORMATION –
RESPONSIBLE PARTY |
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First Name |
MI |
Last Name |
Social Sec.
No. |
Date of
Birth |
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Street
Address |
City |
State |
Zip |
Home Phone |
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CREDIT REFERENCES |
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Bank |
Fax No. |
Contact Phone |
Contact Person |
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Supplier |
Fax No.
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Phone
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Contact |
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Supplier |
Fax No |
Phone |
Contact |
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Supplier |
Fax No |
Phone |
Contact |
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AUTHORIZED PURCHASERS * |
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Name |
Title |
Social Security No. |
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Name |
Title |
Social Security No. |
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The
undersigned understands that this is an application subject to
acceptance and approval by CI. I agree to be bound by the terms and
conditions set forth and incorporated herein and attached hereto.
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Signature |
Print Name & Title |
Date |
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