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Credit Application

Fields marked with * are required

Company Name: *

Company Website: *

Who is your contact at MultiSol? *

Address: *

Country: *

State / Province:

City: *

Zip Code:

Person in Charge of Processing Payment: *

Phone Number: *


Email: *
Number of Years in Business: *
Number of Years At Your Present Address: *
Approximate Annual Sales (in US$): *
Number of Employees: *
Federal Tax ID Number: *
D&B Number (if known):

Please enter information about the company owner, the partners, or corporate officers:

(must be THREE different contacts)

President / CEO / Owner:

Name: *
Email: *
Mobile Phone Number: *


Office Phone Number: *



Financial Manager / CFO:

Name: *
Email: *
Mobile Phone Number: *


Office Phone Number: *



General Manager / Sales Manager:

Name: *
Email: *
Mobile Phone Number: *


Office Phone Number: *



Banking References:

Name of Bank: *
Bank Address: *
Bank Contact: *
Contact Email: *
Bank Telephone: *


Commercial Trade References

(Companies/Vendors who you presently buy from,

preferably in USA)

Trade Reference # 1

Company Name: *
Contact Name: *
Phone Number: *


Email: *

Trade Reference # 2

Company Name: *
Contact Name: *
Phone Number: *


Email: *

Trade Reference # 3

Company Name: *
Contact Name: *
Phone Number: *


Email: *

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