[Company Credit Application] 173 First Street Macon, GA 31201 Office: (478) 746-2124 Fax: (478) 746-2142 Company Name Federal ID Number Physical Address (no P.O. Box) Billing Address City State    Zip Code   Office Number Contact Person’s Number Fax Number Email: Financial Information Bank Name Address   City State Zip Bank Contact Person Account Number Date Opened Credit Rating Credit High Average Balance Credit References Company Name Address  City   State  Zip Contact Person Date Opened Contact Number Credit High Credit Rating Amount Past Due  Amount OwedLast Transaction   Credit References Company Name Address   City State Zip Contact Person Contact Number Date Opened Credit High Credit Rating   Last Transaction Amount Owed Amount Past Due  Credit References Company Name Address   City State Zip Contact Person Contact Number Date Opened Credit High Credit Rating   Last Transaction Amount Owed Amount Past Due  Credit References               Print This Application