Credit Application (Please Print and Fax It Back)

Company Name:_________________________________________________________
Address:_________________________________________________________________
City:_____________________________ State:____________ Zip:__________________
Phone:(        )_____________________ Fax:(        )_____________________
Line of Business:_______________________ No. of Employees:_________________
Description of Goods Sold:__________________________________________________
Resale Certificate No.:__________________________ Year Bus. started:_______________

(Please attach a copy of your resale certificate)

Type of Business: Corporation_____ Sole Ownership_____ Partnership_____

                                                     Business Information

Name of Officer:                                
1.___________________________________________________________________
2.___________________________________________________________________
3.___________________________________________________________________

Bank References

Name:_____________________________ Name:__________________________
Phone:(      )_______________________ Phone:(       )_____________________
Acct. #:____________________________ Acct.#:_________________________

Business References

Name, address, Phone & Fax.

1.____________________________________________________________________
2.____________________________________________________________________
3.____________________________________________________________________

I, _____________________________ am authorized to give my permission for Precision technologies to receive banking information to establish a line of credit for our company.    

                                                                                                                     X________________________
                                                                                                                                                Authorized Signature

                                                                                                                                                 _________________________
                                                                                                                                                 Title